背景:儿童癌症幸存者(CCS)患角质形成细胞癌(KC)的风险增加,单一和多重KC的长期发病率尚不明确.
目的:确定危险因素并量化CCS中的KC累积发病率和多重发病率负担。
方法:在儿童癌症幸存者研究参与者中发现了KC,在北美,一个在1970-1999年间诊断为年龄<21岁的5年癌症幸存者的队列。估计了累积发病率,多变量模型评估了与幸存者和治疗特征相关的KC的相对比率。
结果:在25,658名参与者中,1,446发展为5,363KC(93.5%的基底细胞癌,6.7%鳞状细胞癌;平均年龄37.0岁(范围7.3-67.4),平均潜伏期25.7年;95.3%的白人和88.4%的放疗[RT])。平均病变计数为3.7,其中26.1%的患者≥4。RT使任何KC的速率增加了4.5倍,而≥4KC的速率增加了9.4倍。异基因和自体造血细胞移植与KC增加3.4倍和2.3倍相关,分别。
结论:参与者自我报告的一些数据,包括没有皮肤照片的种族和既往病史可能会影响分析。
结论:CCS中KC的负担仍然很高,但可预测的风险因素应指导筛查。
BACKGROUND: Childhood cancer survivors (CCS) are at increased risk for keratinocyte carcinomas (KC) however, the long-term incidence of single and multiple KC is not well established.
OBJECTIVE: Identify risk factors and quantify KC cumulative incidence and multiple-incidence burden in CCS.
METHODS: KC were identified among Childhood Cancer Survivor Study participants, a cohort of five-year cancer survivors diagnosed <21 years of age between 1970-1999 in North America. Cumulative incidence was estimated, and multivariable models assessed relative rates of KC associated with survivor and treatment characteristics.
RESULTS: Among 25,658 participants, 1,446 developed 5,363 KC (93.5% basal cell carcinoma, 6.7% squamous cell carcinoma; mean age 37.0 years (range 7.3-67.4), mean latency 25.7 years; 95.3% White and 88.4% with radiotherapy [RT]). Mean lesion count was 3.7 with 26.1% experiencing ≥4. RT imparted a 4.5-fold increase in the rate of any KC and 9.4-fold increase in the rate of ≥4 KC. Allogeneic and autologous hematopoietic cell transplant were associated with a 3.4- and 2.3-fold increased rate of KC, respectively.
CONCLUSIONS: Participant self-reporting of some data including race without skin phototype and past medical history may have impacted analysis.
CONCLUSIONS: The burden of KC in CCS remains high, but predictable risk factors should guide screening.