Study finds high risk of gastrointestinal cancers among childhood cancer survivors

June 4, 2012

Survivors of childhood cancers are at an increased risk of another battle with cancer later in life, according to new research published online June 4 by the Annals of Internal Medicine. In the largest study to date of risk for gastrointestinal (GI) cancers among people first diagnosed with cancer before the age of 21, researchers found that childhood cancer survivors develop these malignancies at a rate nearly five times that of the general population.

While there was some preliminary evidence that survivors develop GI cancers more often and at an earlier age than the general population, this is the first study focused on a range of with examination of detailed treatment information including chemotherapy and radiation exposures.

Researchers led by Tara Henderson, MD, MPH, assistant professor of pediatrics and director of the Childhood Cancer Survivors Center at the University of Chicago Medicine, examined 14,358 survivors of Hodgkin lymphoma, non-Hodgkin lymphoma, neuroblastoma, soft tissue sarcoma, Wilms tumor or . They found that survivors were developing secondary GI cancers as soon as five and a half years after a primary cancer diagnosis.

"Due to advancements in therapies, we now have a burgeoning population of childhood cancer survivors," Henderson said. "Sufferers of once nearly unequivocal deadly diseases are thriving well into adulthood. Unfortunately, it appears that for some the impact of along with, in some cases, inherent genetic propensity may set the stage for a second cancer diagnosis. It's an important finding that will hopefully allow us to identify at-risk patients and implement better surveillance in clinical practice."

The mean age of study participants at their initial was 13.9 years, with a mean age of 33.5 at diagnosis of a secondary GI cancer. Henderson points out that these survivors are still relatively young, and considering the median age of 70 for in the general population, it's likely that researchers are seeing only the tip of the iceberg. She anticipates the cumulative incidence of secondary gastrointestinal cancers will continue to increase as this population ages.

The results from the study fell in line with earlier findings suggesting that radiation exposure is a substantial risk factor for second cancers in cancer survivors. Those exposed to abdominal radiation were at the greatest risk — 11.2 times that of the general population. Yet, even who did not receive radiation treatment for their primary cancer were also at increased risk. In addition, the study points to increased risk associated with exposure to high doses of procarbazine and cisplatin chemotherapies.

Study authors agree that because curing the primary childhood cancer remains a priority, they do not advocate modifying the current treatment protocols to decrease the long-term risk for gastrointestinal cancers. "However," Henderson added, "pediatric oncologists continually strive to reduce or eliminate late toxicity without affecting the probability of cure. Therefore, the necessity of therapies such as radiation is under constant scrutiny."

Henderson and her colleagues are calling for screening of for GI cancer earlier than current general guidelines, particularly among those with increased risk factors. They recommend this population be screened every five years, beginning 10 years after radiation treatment, or at age 35, whichever is later. One clear-cut example of the possible impact would be stronger survival rates with early detection of colorectal cancer where the current recommendation is to begin screening at age 50.

"We can't yet predict which patients will face a subsequent , but we can and should devise screening guidelines that take all the risk factors into account," said Henderson. "Waiting until these patients are 50 is simply not enough."

Explore further: Childhood cancer survivors are at increased risk for ongoing post-therapy GI complications

Related Stories

Childhood cancer survivors are at increased risk for ongoing post-therapy GI complications

May 4, 2011
Patients who received therapy for cancer during childhood have an increased risk of developing gastrointestinal (GI) complications later in life, according to a new study in Gastroenterology, the official journal of the American ...

Childhood cancer survivors at greater risk in middle age

June 6, 2011
Scientists at the University of Birmingham have found that survivors of childhood cancers are four times more likely than the general population to develop a new cancer. The results are published online today in the Journal ...

Childhood cancer survivors are at high risk for multiple tumors as they age

June 27, 2011
The largest study yet of adult childhood cancer survivors found that the first cancer is just the beginning of a lifelong battle against different forms of the disease for about 10 percent of these survivors.

Childhood cancer survivors at higher risk for future GI complications

May 20, 2011
(Medical Xpress) -- Individuals who are treated for cancer during childhood have a significantly higher risk of developing gastrointestinal (GI) complications — from mild to severe — later in life, according to ...

Recommended for you

No dye: Cancer patients' gray hair darkened on immune drugs

July 21, 2017
Cancer patients' gray hair unexpectedly turned youthfully dark while taking novel drugs, and it has doctors scratching their heads.

Shooting the achilles heel of nervous system cancers

July 20, 2017
Virtually all cancer treatments used today also damage normal cells, causing the toxic side effects associated with cancer treatment. A cooperative research team led by researchers at Dartmouth's Norris Cotton Cancer Center ...

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

Definitive genomic study reveals alterations driving most medulloblastoma brain tumors

July 19, 2017
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75 percent of the brain tumors, including two new suspected cancer genes that were found exclusively in the least ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.