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Risk of thyroid cancer in survivors of childhood cancer: Results from the British Childhood Cancer Survivor Study
Author(s) -
Taylor Aliki J.,
Croft Adam P.,
Palace Aimee M.,
Winter David L.,
Reulen Raoul C.,
Stiller Charles A.,
Stevens Michael C.G.,
Hawkins Mike M.
Publication year - 2009
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.24581
Subject(s) - medicine , relative risk , thyroid cancer , cancer , radiation therapy , cohort , follicular thyroid cancer , thyroid , cohort study , incidence (geometry) , cumulative incidence , pediatrics , oncology , confidence interval , papillary thyroid cancer , physics , optics
Second primary neoplasms (SPNs) are a recognised late effect of treatment for childhood cancer. Thyroid SPNs can develop after exposure to low‐dose radiation, due to the radio‐sensitivity of the thyroid gland. The British Childhood Cancer Survivor Study (BCCSS) was set up to directly monitor the late effects of treatment, including risk of SPNs, in childhood cancer survivors and includes 17,980 5‐year survivors. We carried out a cohort analysis to determine the risk of thyroid SPNs in the BCCSS, and estimated risk using standardised incidence ratios (SIRs), relative risk (RR) using multivariate Poisson regression and cumulative incidence curves. There were 340,202 person years at risk subsequent to a 5‐year survival, median follow‐up 17.4 years per survivor. We identified 50 thyroid SPNs including 31 (62%) papillary carcinomas, 15 (30%) follicular carcinomas and 4 (8%) other types. 88% of thyroid SPNs developed after exposure to radiotherapy in or around the thyroid gland. SIR overall was 18.0 (95% confidence interval 13.4–23.8). Risk of thyroid cancer was highest after Hodgkin's disease: RR 3.3 (1.1–10.1) and Non Hodgkin's Lymphoma: RR 3.4 (1.1–10.7) relative to leukaemia (RR 1.0) ( p < 0.001). Survivors treated with radiotherapy in childhood had a RR of 4.6 (1.4–15.1) relative to survivors not treated with radiotherapy (RR 1.0), p = 0003. In conclusion, the risk of thyroid cancer in childhood cancer survivors is relatively high in this cohort of childhood cancer survivors. These results will be of use in counselling survivors of childhood cancer exposed to radiation in or around the thyroid area. © 2009 UICC