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Risk of thyroid cancer in survivors of childhood cancer: results from the British Childhood Cancer Survivor Study
International Journal of Cancer, 07/21/09

Taylor AJ et al. - In a trial to directly monitor the late effects of treatment, including risk of second primary neoplasms (SPNs), in childhood cancer survivors, it was found that 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.

Methods

The British Childhood Cancer Survivor Study (BCCSS) includes 17,980 5-yr survivors.
A cohort analysis was done to determine the risk of thyroid SPNs in the BCCSS, and estimate risk using standardised incidence ratios (SIRs), relative risk (RR) using multivariate Poisson regression and cumulative incidence curves.

Results

There were 340,202 person-yrs at risk subsequent to a 5-yr survival, median follow-up 17.4 yrs per survivor.
50 thyroid SPNs were identified 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.
Risk of thyroid cancer was highest after Hodgkin's disease: RR 3.3 and non-Hodgkin's lymphoma: RR 3.4 relative to leukaemia (RR 1.0).
Survivors treated with radiotherapy in childhood had a RR of 4.6 relative to survivors not treated with radiotherapy (RR 1.0).

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