Contributors: 1Centre for Childhood Cancer Survivor Studies, University of Birmingham College of Medical and Dental Sciences, Birmingham, Birmingham, UK. 2National Cancer Registration and Analysis Service, Public Health England, London, UK. 3Childhood Cancer Registry of Piedmont, Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and AOU Città della Salute e della Scienza di Torino, Italy, Childhood cancer registry of piedmont, Turin, Italy. 4Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, University Paris Saclay, Gustave Roussy, Villejuif, France. 5Epidemiology and Biostatistics Unit, Instituto Giannina Gaslini, Genova, Italy. 62nd Department of Pediatrics, Semmelweis University, Budapest, Hungary. 7Kepler Universitätsklinikum, Linz, Austria. 8Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark. 9Boyne Research Institute, Drogheda, Ireland. 10Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands. 11Epidemiology and Prevention Research, Departments of Oncology and Community Health Sciences, Calgary, Alberta, Canada. 12Radiation Epidemiology Team, Center for Research in Epidemiology and Population Health, INSERM U1018, University Paris Saclay, Gustave Roussy, Villejuif, France, Villejuif, France. 13Department of Clinical Sciences, Skåne University Hospital, Lund University, Pediatrics, Lund, Skåne, Sweden. 14German Childhood Cancer Registry, University Medical Centre Mainz, Mainz, Germany. 15Children's Hospital, Landspitali University Hospital, Reykjavik, Iceland. 16Public Health England and NHS England & Improvement, Birmingham, UK. 17Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark. 18Pediatric Clinic, University of Milan-Bicocca, Hospital San Gerardo, Monza, Lombardia, Italy. 19German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany. 20Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, BE, Switzerland. 21Norwegian National Advisory Unit on solid tumors in children, Oslo, Norway. 22Department of pediatric Oncology, Emma Children's Hospital & Academic Medical Center, Amsterdam, The Netherlands. 23Department of Paediatrics, University Children's Hospital of Bern, University of Bern, Bern, BE, Switzerland. 24Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, and Newcastle University Centre for Cancer, Newcastle Upon Tyne, UK. 25Department of Epidemiology, Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 26Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy. 27Norwegian Cancer Registry and Dept. of Pediatric Medicine, Oslo University Hospital and Institute of Clinical Medicine, Faculty of medicine, University of Oslo, Oslo, Norway. 28Hungarian Childhood Cancer Registry, Semmelweis University, 2nd Department of Pediatrics, Budapest, Hungary. 29Epidemiology and Biostatistics Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy. 30Department of Pediatrics and Adolescent Medicine, Turku University and Turku University Hospital, Turku, Finland. 31Division of Radiotherapy, Institute of Oncology, Ljubljana, Slovenia. 32Department of Clinical Medicine, Faculty of Health, Aarhus University and University Hospital, Aarhus, Denmark. 33Centre for Childhood Cancer Survivor Studies, University of Birmingham College of Medical and Dental Sciences, Birmingham, Birmingham, UK m.m.hawkins@bham.ac.uk.
نبذة مختصرة : To access publisher's full text version of this article click on the hyperlink below ; Background: Survivors of childhood cancer are at risk of subsequent primary neoplasms (SPNs), but the risk of developing specific digestive SPNs beyond age 40 years remains uncertain. We investigated risks of specific digestive SPNs within the largest available cohort worldwide. Methods: The PanCareSurFup cohort includes 69 460 five-year survivors of childhood cancer from 12 countries in Europe. Risks of digestive SPNs were quantified using standardised incidence ratios (SIRs), absolute excess risks and cumulative incidence. Results: 427 digestive SPNs (214 colorectal, 62 liver, 48 stomach, 44 pancreas, 59 other) were diagnosed in 413 survivors. Wilms tumour (WT) and Hodgkin lymphoma (HL) survivors were at greatest risk (SIR 12.1; 95% CI 9.6 to 15.1; SIR 7.3; 95% CI 5.9 to 9.0, respectively). The cumulative incidence increased the most steeply with increasing age for WT survivors, reaching 7.4% by age 55% and 9.6% by age 60 years (1.0% expected based on general population rates). Regarding colorectal SPNs, WT and HL survivors were at greatest risk; both seven times that expected. By age 55 years, 2.3% of both WT (95% CI 1.4 to 3.9) and HL (95% CI 1.6 to 3.2) survivors had developed a colorectal SPN-comparable to the risk among members of the general population with at least two first-degree relatives affected. Conclusions: Colonoscopy surveillance before age 55 is recommended in many European countries for individuals with a family history of colorectal cancer, but not for WT and HL survivors despite a comparable risk profile. Clinically, serious consideration should be given to the implementation of colonoscopy surveillance while further evaluation of its benefits, harms and cost-effectiveness in WT and HL survivors is undertaken. Keywords: CANCER EPIDEMIOLOGY; COLORECTAL CANCER; COLORECTAL CANCER SCREENING; GASTROINTESTINAL CANCER. ; European Commission Fondation Force de recherche sur le cancer de l'enfant (FORCE) ...
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