Primary thyroid cancer after a first tumour in childhood (the Childhood Cancer Survivor Study): a nested case-control study

Sigurdson, Alice J.; Ronckers, Cécile M.; Mertens, Ann C.; Stovall, Marilyn; Smith, Susan A.; Liu, Yan; Berkow, Roger L.; Hammond, Sue; Neglia, Joseph P.; Meadows, Anna T.; Sklar, Charles A.; Robison, Leslie L.; Inskip, Peter D.

doi:10.1016/s0140-6736(05)66695-0

Cited by 342 publications

(260 citation statements)

References 33 publications

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“…[6][7][8][9] Childhood cancer survivors who were under the age of 5 at the time of exposure to radiation therapy are reported to be at greatest risk and the risk remains comparatively higher for those under the age of 10 compared to older age groups. 10 In our study, risk was lowest in those aged more than 10 years when compared to the 5-9 and 0-4 year age groups: RR 1.0 (standard), 1.0 (0.4-2.2) and 0.5 (0.2-1.3), respectively although there was no significant difference. Thirty one percent or 62% of the thyroid cancers observed in our study were of the papillary type, SIR overall: 18.3 (12.5-26.1).…”

Section: Discussioncontrasting

confidence: 55%

“…10 Reports from studies of survivors of the Chernobyl accident have reported a high risk of thyroid cancer in children as a consequence of exposure to lowdose radiation. [6][7][8][9] As a result, thyroid carcinoma is a complication of irradiation even when the tissue lies outside the radiation field where the gland is exposed to scatter irradiation.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9] The paediatric thyroid is particularly vulnerable to the oncogenic effects of radiation although there is evidence of cell kill at exposure to radiation doses higher than 3,000 cGy. 10 Thyroid cancer has been frequently reported as a SPN after treatment for childhood cancers including Hodgkin's disease, neuroblastoma and other malignancies that involve radiation to the neck region. [11][12][13] We carried out a cohort study to determine the overall risk of developing a thyroid SPN in 5-year childhood cancer survivors in the British Childhood Cancer Survivor Study (BCCSS).…”

mentioning

confidence: 99%

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Risk of thyroid cancer in survivors of childhood cancer: Results from the British Childhood Cancer Survivor Study

Taylor

Croft

Palace

et al. 2009

Intl Journal of Cancer

100

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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 5 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

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Risk of thyroid cancer in survivors of childhood cancer: Results from the British Childhood Cancer Survivor Study

Taylor

Croft

Palace

et al. 2009

Intl Journal of Cancer

100

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“…This inverse association is supported by data from cohorts exposed to radiotherapy for cancer during childhood (Sigurdson et al, 2005), tinea capitis (Sadetzki et al, 2006), and other benign conditions, as shown in Figure 1A. The results of a pooled analysis, including individuals from six studies who were under the age of 15 at the time of radiation exposure, yielded an ERR per Gy of 7.7 (95% CI: 2.1 -28.7) and an EAR per 10 4 PY Gy of 4.4 (95% CI: 1.9 -10.1) for risk of thyroid cancer.…”

Section: Association Between Age At Exposure and Riskmentioning

confidence: 62%

Childhood exposure to external ionising radiation and solid cancer risk

Sadetzki

Mandelzweig

2009

Br J Cancer

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“…An important risk group for thyroid cancer is childhood cancer survivors who received head and neck irradiation. Thyroid cancers are the most common second malignancy in children who have had lymphomas and the third most frequent malignancy in leukemia survivors [17].…”

Section: Risk Factors For Thyroid Cancer In Childrenmentioning

confidence: 99%

Pediatric Thyroid Cancers: An Indian Perspective

Chaukar

Vaidya

2012

Indian J Surg Oncol

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Pediatric thyroid cancer is a rare entity accounting for less than 5% of all thyroid cancers. This intriguing disease is characterized by advanced presentation, coupled with frequent lymph nodal metastases and often pulmonary metastases. It perhaps exhibits a distinct biology and behaviour, because in spite of its aggressiveness, survival is extremely good. This mandates meticulous treatment decisions that are well executed, because the complications of therapy in patients with good survival may spell prolonged morbidity. Being an unusual disease, it is unlikely that level I evidence guiding the management will come forth. There have been controversies regarding management, and the current consensus comes from large prospective studies. There have been only a few studies from India detailing pediatric thyroid cancers. In the current discussion, we review the existing evidence about pediatric thyroid cancers, and try to have an Indian perspective at the problem.

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Primary thyroid cancer after a first tumour in childhood (the Childhood Cancer Survivor Study): a nested case-control study

Cited by 342 publications

References 33 publications

Risk of thyroid cancer in survivors of childhood cancer: Results from the British Childhood Cancer Survivor Study

Risk of thyroid cancer in survivors of childhood cancer: Results from the British Childhood Cancer Survivor Study

Childhood exposure to external ionising radiation and solid cancer risk

Pediatric Thyroid Cancers: An Indian Perspective

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