Melanoma as a subsequent neoplasm in adult survivors of childhood cancer: A report from the childhood cancer survivor study

A. S. Pappo, Gregory Armstrong, W. Liu, D. K. Srivastava, A. McDonald, W. M. Leisenring, S. Hammond, M. Stovall, J. P. Neglia, L. L. Robison

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Childhood cancer survivors have a sixfold increased risk of developing subsequent neoplasms when compared to the general population. We sought to describe the occurrence of melanoma as a subsequent neoplasm among adult survivors of childhood cancer. Patients and Methods: Among 14,358 5-year survivors of childhood cancer diagnosed between 1970 and 1986, we calculated the cumulative incidence, standardized incidence ratio (SIR), and absolute excess risk (AER) of subsequent melanoma. Potential risk factors were assessed using a cause-specific hazards model. Results: Fifty-seven melanomas (46 invasive, 2 ocular, and 9 in situ) occurred in 51 survivors. The median time to the development of melanoma was 21.0 years (range: 5.6-35.4 years) and the median age at melanoma was 32.3 years (range: 10.9-49.0 years). Initial cancer diagnoses included soft tissue and bone sarcoma (n=15), leukemia (13), lymphoma (14), central nervous system malignancy (5), Wilms tumor (3), and neuroblastoma (1). The cumulative incidence of first subsequent melanoma at 35 years from initial cancer diagnosis was 0.55% [95% confidence interval (CI): 0.37-0.73]. The SIR of subsequent invasive malignant melanoma of the skin was 2.42 (95% CI: 1.77-3.23), and the AER was 0.10 (95% CI: 0.05-0.15) per 1,000 person-years. No statistically significant associations were found between melanoma risk and family history of cancer, demographic, or treatment-related factors. Conclusion: Survivors of childhood cancer have an approximate 2.5-fold increased risk of melanoma. Early screening and prevention strategies are warranted.

Original languageEnglish (US)
Pages (from-to)461-466
Number of pages6
JournalPediatric Blood and Cancer
Volume60
Issue number3
DOIs
StatePublished - Mar 1 2013
Externally publishedYes

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Survivors
Melanoma
Neoplasms
Incidence
Confidence Intervals
Neuroblastoma
Proportional Hazards Models
Sarcoma
Lymphoma
Leukemia
Central Nervous System
Demography
Skin
Population

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Melanoma as a subsequent neoplasm in adult survivors of childhood cancer : A report from the childhood cancer survivor study. / Pappo, A. S.; Armstrong, Gregory; Liu, W.; Srivastava, D. K.; McDonald, A.; Leisenring, W. M.; Hammond, S.; Stovall, M.; Neglia, J. P.; Robison, L. L.

In: Pediatric Blood and Cancer, Vol. 60, No. 3, 01.03.2013, p. 461-466.

Research output: Contribution to journalArticle

Pappo, AS, Armstrong, G, Liu, W, Srivastava, DK, McDonald, A, Leisenring, WM, Hammond, S, Stovall, M, Neglia, JP & Robison, LL 2013, 'Melanoma as a subsequent neoplasm in adult survivors of childhood cancer: A report from the childhood cancer survivor study', Pediatric Blood and Cancer, vol. 60, no. 3, pp. 461-466. https://doi.org/10.1002/pbc.24266
Pappo, A. S. ; Armstrong, Gregory ; Liu, W. ; Srivastava, D. K. ; McDonald, A. ; Leisenring, W. M. ; Hammond, S. ; Stovall, M. ; Neglia, J. P. ; Robison, L. L. / Melanoma as a subsequent neoplasm in adult survivors of childhood cancer : A report from the childhood cancer survivor study. In: Pediatric Blood and Cancer. 2013 ; Vol. 60, No. 3. pp. 461-466.
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abstract = "Background: Childhood cancer survivors have a sixfold increased risk of developing subsequent neoplasms when compared to the general population. We sought to describe the occurrence of melanoma as a subsequent neoplasm among adult survivors of childhood cancer. Patients and Methods: Among 14,358 5-year survivors of childhood cancer diagnosed between 1970 and 1986, we calculated the cumulative incidence, standardized incidence ratio (SIR), and absolute excess risk (AER) of subsequent melanoma. Potential risk factors were assessed using a cause-specific hazards model. Results: Fifty-seven melanomas (46 invasive, 2 ocular, and 9 in situ) occurred in 51 survivors. The median time to the development of melanoma was 21.0 years (range: 5.6-35.4 years) and the median age at melanoma was 32.3 years (range: 10.9-49.0 years). Initial cancer diagnoses included soft tissue and bone sarcoma (n=15), leukemia (13), lymphoma (14), central nervous system malignancy (5), Wilms tumor (3), and neuroblastoma (1). The cumulative incidence of first subsequent melanoma at 35 years from initial cancer diagnosis was 0.55{\%} [95{\%} confidence interval (CI): 0.37-0.73]. The SIR of subsequent invasive malignant melanoma of the skin was 2.42 (95{\%} CI: 1.77-3.23), and the AER was 0.10 (95{\%} CI: 0.05-0.15) per 1,000 person-years. No statistically significant associations were found between melanoma risk and family history of cancer, demographic, or treatment-related factors. Conclusion: Survivors of childhood cancer have an approximate 2.5-fold increased risk of melanoma. Early screening and prevention strategies are warranted.",
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T2 - A report from the childhood cancer survivor study

AU - Pappo, A. S.

AU - Armstrong, Gregory

AU - Liu, W.

AU - Srivastava, D. K.

AU - McDonald, A.

AU - Leisenring, W. M.

AU - Hammond, S.

AU - Stovall, M.

AU - Neglia, J. P.

AU - Robison, L. L.

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N2 - Background: Childhood cancer survivors have a sixfold increased risk of developing subsequent neoplasms when compared to the general population. We sought to describe the occurrence of melanoma as a subsequent neoplasm among adult survivors of childhood cancer. Patients and Methods: Among 14,358 5-year survivors of childhood cancer diagnosed between 1970 and 1986, we calculated the cumulative incidence, standardized incidence ratio (SIR), and absolute excess risk (AER) of subsequent melanoma. Potential risk factors were assessed using a cause-specific hazards model. Results: Fifty-seven melanomas (46 invasive, 2 ocular, and 9 in situ) occurred in 51 survivors. The median time to the development of melanoma was 21.0 years (range: 5.6-35.4 years) and the median age at melanoma was 32.3 years (range: 10.9-49.0 years). Initial cancer diagnoses included soft tissue and bone sarcoma (n=15), leukemia (13), lymphoma (14), central nervous system malignancy (5), Wilms tumor (3), and neuroblastoma (1). The cumulative incidence of first subsequent melanoma at 35 years from initial cancer diagnosis was 0.55% [95% confidence interval (CI): 0.37-0.73]. The SIR of subsequent invasive malignant melanoma of the skin was 2.42 (95% CI: 1.77-3.23), and the AER was 0.10 (95% CI: 0.05-0.15) per 1,000 person-years. No statistically significant associations were found between melanoma risk and family history of cancer, demographic, or treatment-related factors. Conclusion: Survivors of childhood cancer have an approximate 2.5-fold increased risk of melanoma. Early screening and prevention strategies are warranted.

AB - Background: Childhood cancer survivors have a sixfold increased risk of developing subsequent neoplasms when compared to the general population. We sought to describe the occurrence of melanoma as a subsequent neoplasm among adult survivors of childhood cancer. Patients and Methods: Among 14,358 5-year survivors of childhood cancer diagnosed between 1970 and 1986, we calculated the cumulative incidence, standardized incidence ratio (SIR), and absolute excess risk (AER) of subsequent melanoma. Potential risk factors were assessed using a cause-specific hazards model. Results: Fifty-seven melanomas (46 invasive, 2 ocular, and 9 in situ) occurred in 51 survivors. The median time to the development of melanoma was 21.0 years (range: 5.6-35.4 years) and the median age at melanoma was 32.3 years (range: 10.9-49.0 years). Initial cancer diagnoses included soft tissue and bone sarcoma (n=15), leukemia (13), lymphoma (14), central nervous system malignancy (5), Wilms tumor (3), and neuroblastoma (1). The cumulative incidence of first subsequent melanoma at 35 years from initial cancer diagnosis was 0.55% [95% confidence interval (CI): 0.37-0.73]. The SIR of subsequent invasive malignant melanoma of the skin was 2.42 (95% CI: 1.77-3.23), and the AER was 0.10 (95% CI: 0.05-0.15) per 1,000 person-years. No statistically significant associations were found between melanoma risk and family history of cancer, demographic, or treatment-related factors. Conclusion: Survivors of childhood cancer have an approximate 2.5-fold increased risk of melanoma. Early screening and prevention strategies are warranted.

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