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Childhood cancer survivors face markedly worse overall survival after diagnosis with breast cancer, melanoma, or colorectal cancer
Author(s) -
Lynch Kevin T.,
Kane William J.,
Fleming Mark A.,
Desai Raj P.,
Showalter Shayna L.,
Slingluff Craig L.,
Levin Daniel E.,
Hedrick Traci L.
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26478
Subject(s) - medicine , breast cancer , cancer , colorectal cancer , hazard ratio , melanoma , oncology , family history , malignancy , cohort , epidemiology , young adult , cancer registry , confidence interval , cancer research
Background Childhood cancer survivors (CCS) are at elevated risk of secondary malignancies (SM). Enhanced screening for SM is recommended, but compliance is poor. We hypothesized that CCS with adult‐onset SM (colorectal cancer [CRC], melanoma, or breast cancer [BC]) would present with more advanced disease and have decreased overall survival (OS). Methods The Surveillance, Epidemiology, and End Results Program was queried for patients diagnosed with cancer at age less than or equal to 18 also diagnosed with adult‐onset CRC, melanoma, or BC. A cohort without a history of prior malignancy was likewise identified. Tumor features and clinical outcomes were compared. Results CCS with a SM ( n = 224) were compared with patients without a childhood cancer history ( n = 1,392,670). CCS were diagnosed younger (BC = 37.6 vs. 61.3, p < 0.01, CRC = 35.0 vs. 67.1, p < 0.01, melanoma = 29.6 vs. 61.3 years old, p < 0.01). CCS with BC were more likely to have Stage III or IV disease (25.2% vs. 16.5%, p = 0.01). Hormone‐receptor expression also differed; CCS were less likely to develop Luminal A‐type tumors (48.6% vs. 66.9%, p = 0.01). After age‐adjustment, CCS had worse OS (Hazard ratio: CRC = 2.449, p < 0.01, melanoma = 6.503, p < 0.01, BC = 3.383, p < 0.01). Conclusion CCS were younger when diagnosed with a SM. After age‐adjustment, OS was diminished. Heightened surveillance may be necessary for CCS diagnosed with SM.