Journal of the National Cancer Institute · 2026
Mortality after colorectal cancer among survivors of childhood cancer.
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Major Ajay, Chou Joanne, Lam Helen, Kim Karen E, Turcotte Lucie M, Leisenring Wendy, Yasui Yutaka, Neglia Joseph P, Curry Michael, Howell Rebecca M, Oeffinger Kevin C, Hodgson David, Nathan Paul C, Armstrong Greg T, Moskowitz Chaya S, Henderson Tara O
Аннотация
Mortality after diagnosis of colorectal subsequent malignant neoplasms (CRC-SMN) among childhood cancer survivors is understudied. Using data from the Childhood Cancer Survivor Study (CCSS) and the Surveillance, Epidemiology, and End Results (SEER) program, we compared all-cause mortality of survivors with CRC-SMN with survivors without CRC-SMN and CRC patients in the general population without a childhood cancer history. Among 25 656 childhood cancer survivors, 96 developed CRC-SMN, with 50% diagnosed before age 40 years and 19% before age 30 years. Of those diagnosed before age 40 years, 35% had no prior abdominal- or pelvic-directed radiation therapy. The cumulative incidence of CRC-SMN in CCSS survivors was 0.7% (95% CI = 0.5% to 0.9%) by age 45 years and 1.1% (95% CI = 0.8% to 1.4%) by age 50 years. There were 31 deaths after CRC-SMN. Adjusted all-cause mortality was threefold higher (hazard ratio [HR] = 3.34, 95% CI = 2.25 to 4.59) than for survivors without CRC and statistically significantly higher for survivors diagnosed younger than age 30 years compared with SEER CRC patients (HR = 2.51, 95% CI = 1.29 to 4.89).