Risk of Salivary Gland Cancer After Childhood Cancer: A Report From the Childhood Cancer Survivor Study
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States)
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington (United States)
- Department of Pathology, Ohio State University School of Medicine, Columbus, Ohio (United States)
- Department of Pediatrics, Emory University, Atlanta, Georgia (United States)
- Department of Radiation Oncology, Stanford University Medical Center, Stanford, California (United States)
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (United States)
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota (United States)
Purpose: To evaluate effects of radiation therapy, chemotherapy, cigarette smoking, and alcohol consumption on the risk of second primary salivary gland cancer (SGC) in the Childhood Cancer Survivor Study (CCSS). Methods and Materials: Standardized incidence ratios (SIR) and excess absolute risks (EAR) of SGC in the CCSS were calculated using incidence rates from Surveillance, Epidemiology, and End Results population-based cancer registries. Radiation dose to the salivary glands was estimated based on medical records. Poisson regression was used to assess risks with respect to radiation dose, chemotherapy, smoking, and alcohol consumption. Results: During the time period of the study, 23 cases of SGC were diagnosed among 14,135 childhood cancer survivors. The mean age at diagnosis of the first primary cancer was 8.3 years, and the mean age at SGC diagnosis was 24.8 years. The incidence of SGC was 39-fold higher in the cohort than in the general population (SIR = 39.4; 95% CI = 25.4-57.8). The EAR was 9.8 per 100,000 person-years. Risk increased linearly with radiation dose (excess relative risk = 0.36/Gy; 95% CI = 0.06-2.5) and remained elevated after 20 years. There was no significant trend of increasing risk with increasing dose of chemotherapeutic agents, pack-years of cigarette smoking, or alcohol intake. Conclusion: Although the cumulative incidence of SGC was low, childhood cancer survivors treated with radiation experienced significantly increased risk for at least 2 decades after exposure, and risk was positively associated with radiation dose. Results underscore the importance of long-term follow up of childhood cancer survivors for the development of new malignancies.
- OSTI ID:
- 22224379
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 85, Issue 3; Other Information: Copyright (c) 2013 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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