br Author statement Baozhen Qiao study design cancer data
Author statement Baozhen Qiao: study design, cancer data preparation, data linkage, manual review of uncertain matches, analysis of data, interpretation of the results, drafting the manuscript, final approval of the article April A Austin: study design, birth defects data preparation, interpretation of the results, critical revision of the manuscript, final approval of the article Maria J Schymura: study design, interpretation of the results, critical revision of the manuscript, final approval of the article Marilyn L Browne: study design, birth defects data preparation, interpretation of the results, critical revision of the manuscript, final approval of the article
Declarations of interest
Acknowledgements This project was supported in part by the Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries (NPCR) through cooperative agreement number 5NU58DP006309 awarded to the New York State Department of Health. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.
Introduction Cancer is a major cause of death among children ages 0–19 worldwide and incidence is increasing in this ATPγS tetralithium salt . Five years survival rates of childhood cancer have improved dramatically, from less than 60% in 1975 to over 80% in 2010 , mostly due to substantial improvements in the effectiveness of treatment. However, some studies have reported that cancer survivors are at higher risk than their peers in the general population for subsequent morbidity and death, primarily as a result of recurrence of their primary cancer, but also due to side-effects of treatment, leading to secondary cancers and cardiac disease [3,4]. The North American Childhood Cancer Survivor Cohort Study (CCSS) reported a cumulative risk of developing a second malignancy of 3.2% at 20 years and 9.3% at 30 years of follow-up . A regional population-based cohort study in Ontario indicated that survivors of childhood cancer were 9 times more likely than peers to develop a second malignancy and that 40% of second primary cancers occurred within 5 years of the first diagnosis . To date, few studies have used national registry data to carry out long-term follow up outcomes among survivors of cancers diagnosed in childhood and adolescence. The objectives of hominoid study were (i) to estimate, using national registry data, the risk of second primary neoplasm (SPN) and long-term mortality among 5+y childhood cancer survivors in Israel, compared to their peers in the general population; and (ii) to explore the impact of demographic and disease-related characteristics on the risks of SPN and long-term mortality among childhood cancer survivors.
Results A total of 8855 children were diagnosed during 1980–2007 with INCR-reportable diseases. 6637 survived at least 5 years following FPN diagnosis. Approximately 54% were males, and the average age at diagnosis was 9.4 years (SD = 6.07). The most frequent childhood FPN's among 5+ year survivors (23.1%) were lymphoma and reticuloendothelial neoplasms (Table 1). In total, 340 (4.5%) subjects died due to any cause during the follow-up period, and 57.4% were males. The average age at death was 20.6 years (SD = 7.57). Of the subjects who died during the follow up, 23.5% had been diagnosed with leukemia, myeloproliferative disease or myelodysplastic disease as the FPN (Table 1).
Discussion The current study explored the risks for SPN and mortality among 5+y survivors of childhood cancer. The baseline (FPN) characteristics of our cohort are consistent with the current literature related to childhood cancer cohort studies , with higher incidence among males compared to females, and with the expected site distribution (hematologic malignancies being the most commonly diagnosed type) [12,13].