Jop C Teepen1, Suzanne L de Vroom2, Flora E van Leeuwen3, Wim J Tissing4, Leontien C Kremer2, Cécile M Ronckers2. 1. Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands. Electronic address: j.c.teepen@amc.uva.nl. 2. Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands. 3. Department of Epidemiology, The Netherlands Cancer Institute, P.O. Box 90203, 1066 CX Amsterdam, The Netherlands. 4. Department of Pediatric Oncology and Hematology, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Abstract
BACKGROUND: Childhood cancer survivors (CCS) are at increased risk of developing subsequent malignant neoplasms, including gastrointestinal (GI) cancer. We performed a systematic review to summarize all available literature on the risk of, risk factors for, and outcome after subsequent GI cancer among CCS. METHODS: A systematic search of the literature databases Medline/PubMed (1945-2014) and Embase (1947-2014) was performed to identify studies that consisted of ⩾1000 CCS and assessed incidence of or mortality from subsequent GI cancer as an outcome. RESULTS: A total of 45 studies were included. Studies that reported risk measures for subsequent GI cancer compared to the general population showed a 3.2 to 9.7-fold elevated risk in cohort studies including all childhood cancer types. Abdominal radiotherapy was associated with an increased risk of subsequent GI cancer in all four studies that assessed this risk. Survivors who had received procarbazine and platinum agents were also suggested to be at increased risk. CONCLUSION: Abdominal radiotherapy is a risk factor for developing a subsequent GI cancer. Few studies examined detailed treatment-related risk factors and most studies had small number of GI cancer cases. Therefore, no conclusions could be drawn on the effect of time since childhood cancer on GI cancer risk and on outcome after a subsequent GI cancer. Additional research is necessary to further explore risk factors for and outcome after a subsequent GI cancer, and to systematically evaluate the harms and benefits of GI screening among high-risk survivors in order to give sound screening recommendations.
BACKGROUND: Childhood cancer survivors (CCS) are at increased risk of developing subsequent malignant neoplasms, including gastrointestinal (GI) cancer. We performed a systematic review to summarize all available literature on the risk of, risk factors for, and outcome after subsequent GI cancer among CCS. METHODS: A systematic search of the literature databases Medline/PubMed (1945-2014) and Embase (1947-2014) was performed to identify studies that consisted of ⩾1000 CCS and assessed incidence of or mortality from subsequent GI cancer as an outcome. RESULTS: A total of 45 studies were included. Studies that reported risk measures for subsequent GI cancer compared to the general population showed a 3.2 to 9.7-fold elevated risk in cohort studies including all childhood cancer types. Abdominal radiotherapy was associated with an increased risk of subsequent GI cancer in all four studies that assessed this risk. Survivors who had received procarbazine and platinum agents were also suggested to be at increased risk. CONCLUSION: Abdominal radiotherapy is a risk factor for developing a subsequent GI cancer. Few studies examined detailed treatment-related risk factors and most studies had small number of GI cancer cases. Therefore, no conclusions could be drawn on the effect of time since childhood cancer on GI cancer risk and on outcome after a subsequent GI cancer. Additional research is necessary to further explore risk factors for and outcome after a subsequent GI cancer, and to systematically evaluate the harms and benefits of GI screening among high-risk survivors in order to give sound screening recommendations.
Authors: Michael Hauptmann; Tom Børge Johannesen; Ethel S Gilbert; Marilyn Stovall; Flora E van Leeuwen; Preetha Rajaraman; Susan A Smith; Rita E Weathers; Berthe M P Aleman; Michael Andersson; Rochelle E Curtis; Graça M Dores; Joseph F Fraumeni; Per Hall; Eric J Holowaty; Heikki Joensuu; Magnus Kaijser; Ruth A Kleinerman; Frøydis Langmark; Charles F Lynch; Eero Pukkala; Hans H Storm; Leila Vaalavirta; Alexandra W van den Belt-Dusebout; Lindsay M Morton; Sophie D Fossa; Lois B Travis Journal: Br J Cancer Date: 2016-09-06 Impact factor: 7.640
Authors: Lisanne S Rigter; Manon C W Spaander; Berthe M P Aleman; Tanya M Bisseling; Leon M Moons; Annemieke Cats; Pieternella J Lugtenburg; Cecile P M Janus; Eefke J Petersen; Judith M Roesink; Richard W M van der Maazen; Petur Snaebjornsson; Ernst J Kuipers; Marco J Bruno; Evelien Dekker; Gerrit A Meijer; Jan Paul de Boer; Flora E van Leeuwen; Monique E van Leerdam Journal: Cancer Date: 2018-12-18 Impact factor: 6.860