Increased risk of second malignant neoplasms in adolescents and young adults with cancer

Jean S. Lee, Steven G. Dubois, Peter Felix Coccia, Archie Bleyer, Rebecca L. Olin, Robert E. Goldsby

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

BACKGROUND The authors describe the incidence and characteristics of secondary malignant neoplasms (SMNs) in adolescent and young adult (AYA) cancer survivors compared with those in younger and older cancer survivors. METHODS Children aged ≤14 years, AYAs aged 15 to 39, and older adults aged ≥40 years at the time of primary diagnosis who were reported as cancer survivors in the Surveillance, Epidemiology, and End Results (SEER) program between 1973 and 2011 were compared in this population-based analysis. The primary analysis was the risk that an SMN would occur ≥5 years after the original diagnosis for patients who had the more common AYA cancers (leukemia, lymphoma, testicular malignancy, ovarian malignancy, melanoma, and cancers of the thyroid, breast, soft tissue, or bone). The standardized incidence ratio (SIR), absolute excess risk (AER), and cumulative incidence of SMN for the selected cancers were assessed. The risk of SMN for the entire cohort also was analyzed. RESULTS Of the 148,558 AYA survivors who were diagnosed with a selected cancer, 7384 developed an SMN 5 years after their original diagnosis. The SIRs (95% confidence intervals [CIs]) were 1.58 (95% CI, 1.55-1.62) for AYAs, 4.26 (95% CI, 3.77-4.80) for children, and 1.10 (95% CI, 1.09-1.11) for older adults, and the AERs were 22.9, 16.6, and 14.7, respectively. The cumulative incidence of SMN at 30 years was 13.9% for the AYA group. The most common SMNs in AYAs were breast cancer, gastrointestinal cancer, genital cancers, and melanoma. AYAs who had received radiation therapy had a higher cumulative incidence of SMN. CONCLUSIONS AYAs who survive cancer for more than 5 years have a higher relative risk of SMN compared with the general population and have a higher absolute risk of SMN compared with younger or older cancer survivors. Cancer 2016;122:116-123.

Original languageEnglish (US)
Pages (from-to)116-123
Number of pages8
JournalCancer
Volume122
Issue number1
DOIs
StatePublished - Jan 1 2016

Fingerprint

Second Primary Neoplasms
Young Adult
Neoplasms
Survivors
Confidence Intervals
Incidence
Melanoma
SEER Program
Breast Neoplasms

Keywords

  • adolescents and young adults
  • late effects
  • pediatric oncology
  • radiation
  • second malignant neoplasms

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Lee, J. S., Dubois, S. G., Coccia, P. F., Bleyer, A., Olin, R. L., & Goldsby, R. E. (2016). Increased risk of second malignant neoplasms in adolescents and young adults with cancer. Cancer, 122(1), 116-123. https://doi.org/10.1002/cncr.29685

Increased risk of second malignant neoplasms in adolescents and young adults with cancer. / Lee, Jean S.; Dubois, Steven G.; Coccia, Peter Felix; Bleyer, Archie; Olin, Rebecca L.; Goldsby, Robert E.

In: Cancer, Vol. 122, No. 1, 01.01.2016, p. 116-123.

Research output: Contribution to journalArticle

Lee, JS, Dubois, SG, Coccia, PF, Bleyer, A, Olin, RL & Goldsby, RE 2016, 'Increased risk of second malignant neoplasms in adolescents and young adults with cancer', Cancer, vol. 122, no. 1, pp. 116-123. https://doi.org/10.1002/cncr.29685
Lee JS, Dubois SG, Coccia PF, Bleyer A, Olin RL, Goldsby RE. Increased risk of second malignant neoplasms in adolescents and young adults with cancer. Cancer. 2016 Jan 1;122(1):116-123. https://doi.org/10.1002/cncr.29685
Lee, Jean S. ; Dubois, Steven G. ; Coccia, Peter Felix ; Bleyer, Archie ; Olin, Rebecca L. ; Goldsby, Robert E. / Increased risk of second malignant neoplasms in adolescents and young adults with cancer. In: Cancer. 2016 ; Vol. 122, No. 1. pp. 116-123.
@article{ecd77ff3dfe846d9add7550d84f5ad0e,
title = "Increased risk of second malignant neoplasms in adolescents and young adults with cancer",
abstract = "BACKGROUND The authors describe the incidence and characteristics of secondary malignant neoplasms (SMNs) in adolescent and young adult (AYA) cancer survivors compared with those in younger and older cancer survivors. METHODS Children aged ≤14 years, AYAs aged 15 to 39, and older adults aged ≥40 years at the time of primary diagnosis who were reported as cancer survivors in the Surveillance, Epidemiology, and End Results (SEER) program between 1973 and 2011 were compared in this population-based analysis. The primary analysis was the risk that an SMN would occur ≥5 years after the original diagnosis for patients who had the more common AYA cancers (leukemia, lymphoma, testicular malignancy, ovarian malignancy, melanoma, and cancers of the thyroid, breast, soft tissue, or bone). The standardized incidence ratio (SIR), absolute excess risk (AER), and cumulative incidence of SMN for the selected cancers were assessed. The risk of SMN for the entire cohort also was analyzed. RESULTS Of the 148,558 AYA survivors who were diagnosed with a selected cancer, 7384 developed an SMN 5 years after their original diagnosis. The SIRs (95{\%} confidence intervals [CIs]) were 1.58 (95{\%} CI, 1.55-1.62) for AYAs, 4.26 (95{\%} CI, 3.77-4.80) for children, and 1.10 (95{\%} CI, 1.09-1.11) for older adults, and the AERs were 22.9, 16.6, and 14.7, respectively. The cumulative incidence of SMN at 30 years was 13.9{\%} for the AYA group. The most common SMNs in AYAs were breast cancer, gastrointestinal cancer, genital cancers, and melanoma. AYAs who had received radiation therapy had a higher cumulative incidence of SMN. CONCLUSIONS AYAs who survive cancer for more than 5 years have a higher relative risk of SMN compared with the general population and have a higher absolute risk of SMN compared with younger or older cancer survivors. Cancer 2016;122:116-123.",
keywords = "adolescents and young adults, late effects, pediatric oncology, radiation, second malignant neoplasms",
author = "Lee, {Jean S.} and Dubois, {Steven G.} and Coccia, {Peter Felix} and Archie Bleyer and Olin, {Rebecca L.} and Goldsby, {Robert E.}",
year = "2016",
month = "1",
day = "1",
doi = "10.1002/cncr.29685",
language = "English (US)",
volume = "122",
pages = "116--123",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "1",

}

TY - JOUR

T1 - Increased risk of second malignant neoplasms in adolescents and young adults with cancer

AU - Lee, Jean S.

AU - Dubois, Steven G.

AU - Coccia, Peter Felix

AU - Bleyer, Archie

AU - Olin, Rebecca L.

AU - Goldsby, Robert E.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - BACKGROUND The authors describe the incidence and characteristics of secondary malignant neoplasms (SMNs) in adolescent and young adult (AYA) cancer survivors compared with those in younger and older cancer survivors. METHODS Children aged ≤14 years, AYAs aged 15 to 39, and older adults aged ≥40 years at the time of primary diagnosis who were reported as cancer survivors in the Surveillance, Epidemiology, and End Results (SEER) program between 1973 and 2011 were compared in this population-based analysis. The primary analysis was the risk that an SMN would occur ≥5 years after the original diagnosis for patients who had the more common AYA cancers (leukemia, lymphoma, testicular malignancy, ovarian malignancy, melanoma, and cancers of the thyroid, breast, soft tissue, or bone). The standardized incidence ratio (SIR), absolute excess risk (AER), and cumulative incidence of SMN for the selected cancers were assessed. The risk of SMN for the entire cohort also was analyzed. RESULTS Of the 148,558 AYA survivors who were diagnosed with a selected cancer, 7384 developed an SMN 5 years after their original diagnosis. The SIRs (95% confidence intervals [CIs]) were 1.58 (95% CI, 1.55-1.62) for AYAs, 4.26 (95% CI, 3.77-4.80) for children, and 1.10 (95% CI, 1.09-1.11) for older adults, and the AERs were 22.9, 16.6, and 14.7, respectively. The cumulative incidence of SMN at 30 years was 13.9% for the AYA group. The most common SMNs in AYAs were breast cancer, gastrointestinal cancer, genital cancers, and melanoma. AYAs who had received radiation therapy had a higher cumulative incidence of SMN. CONCLUSIONS AYAs who survive cancer for more than 5 years have a higher relative risk of SMN compared with the general population and have a higher absolute risk of SMN compared with younger or older cancer survivors. Cancer 2016;122:116-123.

AB - BACKGROUND The authors describe the incidence and characteristics of secondary malignant neoplasms (SMNs) in adolescent and young adult (AYA) cancer survivors compared with those in younger and older cancer survivors. METHODS Children aged ≤14 years, AYAs aged 15 to 39, and older adults aged ≥40 years at the time of primary diagnosis who were reported as cancer survivors in the Surveillance, Epidemiology, and End Results (SEER) program between 1973 and 2011 were compared in this population-based analysis. The primary analysis was the risk that an SMN would occur ≥5 years after the original diagnosis for patients who had the more common AYA cancers (leukemia, lymphoma, testicular malignancy, ovarian malignancy, melanoma, and cancers of the thyroid, breast, soft tissue, or bone). The standardized incidence ratio (SIR), absolute excess risk (AER), and cumulative incidence of SMN for the selected cancers were assessed. The risk of SMN for the entire cohort also was analyzed. RESULTS Of the 148,558 AYA survivors who were diagnosed with a selected cancer, 7384 developed an SMN 5 years after their original diagnosis. The SIRs (95% confidence intervals [CIs]) were 1.58 (95% CI, 1.55-1.62) for AYAs, 4.26 (95% CI, 3.77-4.80) for children, and 1.10 (95% CI, 1.09-1.11) for older adults, and the AERs were 22.9, 16.6, and 14.7, respectively. The cumulative incidence of SMN at 30 years was 13.9% for the AYA group. The most common SMNs in AYAs were breast cancer, gastrointestinal cancer, genital cancers, and melanoma. AYAs who had received radiation therapy had a higher cumulative incidence of SMN. CONCLUSIONS AYAs who survive cancer for more than 5 years have a higher relative risk of SMN compared with the general population and have a higher absolute risk of SMN compared with younger or older cancer survivors. Cancer 2016;122:116-123.

KW - adolescents and young adults

KW - late effects

KW - pediatric oncology

KW - radiation

KW - second malignant neoplasms

UR - http://www.scopus.com/inward/record.url?scp=84961575105&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84961575105&partnerID=8YFLogxK

U2 - 10.1002/cncr.29685

DO - 10.1002/cncr.29685

M3 - Article

VL - 122

SP - 116

EP - 123

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 1

ER -