Second malignant neoplasms after cancer in childhood or adolescence. Nordic Society of Paediatric Haematology and Oncology Association of the Nordic Cancer Registries.

Abstract

Encouraging patients to reduce or stop smoking is an important aspect of care. Smoking habits were recorded in 76% of patients, which compares well with the 44% found in an audit in 12 Oxfordshire practices in 1986.24 Results-247 cases of second malignant neoplasms were observed in 238 patients, yielding a relative risk for cancer of 3-6 (95% confidence interval 3-1 to 4.1). The risk changed significantly from 2*6 in people first diagnosed during the 1940s and 1950s to 6-9 among cohort members included in the late 1970s and 1980s. Increases were observed for most types of cancer. Highest levels of the relative risk were seen during the 10 years immediately after first malignant diagnosis. The incidence of second malignant neoplasms attributable to the first cancer and associated treatments, however, showed a consistent rise throughout the 45 years offollow up.Conclusion-The estimated risks for a second malignant neoplasm were significantly lower than those found in most large hospital based studies but compatible with the results from a similar population based study in the United Kingdom. Extent of risk and cancer pattern were similar among the Nordic countries and are believed to be representative for a large part ofthe European population.

Second malignancies after childhood noncentral nervous system solid cancer: Results from 13 cancer registries

“…The registries contributed data for different time periods in the years 1943 to 2000, with a median observation period of 32 years. This dataset partially overlaps with the populations included in previous studies from the Nordic countries 9,11,13 and Slovenia.…”

Second primary malignancies among patients with soft tissue tumors in Sweden

“…18,20,35 High-dose radiation and alkylating agent therapy have been suggested to be associated with these excesses, 36 and therapeutic effects may partly explain the observed increase in the late follow-up period in this study. The high frequency within the first year of follow-up may be explained by tumor recurrence or intensive medical surveillance.…”

Survivors of Childhood Cancer for More than Twenty Years

“…The estimated risk of developing a second malignant neoplasm (SMN) is 3± 4% for all pediatric cancer survivors (16,17). In a recent report, 28 of 182 former patients with Hodgkin's disease during childhood or adolescence were identi® ed with a SMN (18).…”