Table 4.
Observed (O) and expected (E) cancer incidence and standardized incidence ratios (SIR) among 1082 five-year survivors of pediatric non-Hodgkin lymphoma (NHL): Childhood Cancer Survivor Study, North America
| Incident second cancer | Self-reported second cancer |
Self-reported second cancer and cancer cases identified on death certificates* |
||||
|---|---|---|---|---|---|---|
| O | E | SIR (95% CI) | EAR | O | SIR (95% CI) | |
| Any malignancy† | 31 | 8.9 | 3.5 (2.4, 5.0) | 13.1 | 34 | 3.8 (2.7, 5.4) |
| Lymphomas and hematopoietic cancer | ||||||
| Lymphoma | 3 | 1.4 | 2.1 (0.4, 6.2) | 0.9 | 3 | 2.1 (0.4, 6.2) |
| NHL | 1 | 0.7 | ND | 0.2 | 1 | ND |
| Hodgkin lymphoma | 2 | 0.7 | 2.8 (0.3, 10.1) | 0.8 | 2 | 2.8 (0.3, 10.1) |
| Leukemia | 1 | 0.5 | ND | 0.3 | 3 | 6.5 (1.3, 18.9) |
| Any solid nonhematologic tumor | 27 | 6.9 | 3.9 (2.6, 5.7) | 11.9 | 28 | 4.1 (2.7, 5.9) |
| Breast | 6 | 0.7 | 9.1 (3.3, 19.7) | 3.2 | 6 | 9.1 (3.3, 19.7) |
| Thyroid | 6 | 0.6 | 9.4 (3.5, 20.5) | 3.2 | 6 | 9.4 (3.5, 20.5) |
| Oral cavity and pharynx | 3 | 0.2 | 14.4 (2.9, 42.1) | 1.7 | 3 | 14.4 (2.9, 42.1) |
| Bones and joints | 2 | 0.2 | 11.6 (1.3, 41.8) | 1.1 | 2 | 11.6 (1.3, 41.8) |
| Brain and nervous system | 3 | 0.5 | 5.8 (1.2, 16.8) | 1.5 | 4 | 7.7 (2.1, 19.7) |
| Urinary bladder | 2 | 0.1 | 14.5 (1.6, 52.2) | 1.1 | 2 | 14.5 (1.6, 52.2) |
| Others | 5‡ | ND | ND | ND | 5‡ | ND |
O indicates observed number of cancers; E, expected number of cancers; SIR, standardized incidence ratio; CI, confidence interval; EAR, excess absolute risks (expressed per 10,000 person-years); ND, not determined (estimates presented where there are two or more observed cancers).
For deceased study participants whose family member filled out the study questionnaire, there were three cases in which a SMN was not reported but was present on the death certificate and where the date of death preceded the last questionnaire. Cases included one cranial nerve neoplasm and two acute myeloid leukemias.
Excluded were: five cancers reported less than five years after NHL diagnosis: fibrillary astrocytoma, osteosarcoma of bone/joint, sarcoma of bone/joint, salivary gland carcinoma, and lymphoblastic lymphoma; two incident third malignancies: cancer of the parotid gland after papillary thyroid cancer, and renal cell carcinoma after endometrial cancer; four cancer diagnoses identified on death certificates but not on a subsequent questionnaire: two AMLs and two brain cancers, four meningiomas, one myelodysplastic syndrome, and 49 non-melanoma skin cancers in 24 individuals.
One solid tumor occurred at each of the following sites: colon, skin (melanoma), uterus, vulva, and testis.