Table 2.
Radiation-related risks of second (or subsequent) primary cancers among childhood cancer survivors, by type of subsequent cancer.
| Site (Type) of Subsequent Cancer |
Number of.Cases (with dose) |
ERR/Gy (95% CI) | P-value* | Statistical Evidence of Curvilinearity of Dose- Response? |
Usual Types of First Cancer Among Cases |
Reference Number |
|---|---|---|---|---|---|---|
| Brain/CNS (glioma) |
35 | 0.33¥ (0.07–1.71) | < .001 | No | Leukemia, CNS | 10 |
| Brain/CNS (meningioma) |
58 | 1.06¥ (0.21–8.15) | < .001 | No | Leukemia, CNS | 10 |
| Breast | 107 | 0.27¥¥ (0.10–0.67) | < .0001 | No | HL, bone | 11 |
| Thyroid gland | 115 | 1.38# | < .001* | Yes (downward at very high doses) |
HL, leukemia, CNS, bone |
12–15 |
| Bone/soft tissue |
84 | 1.32¶ (0.44–4.22) | <.001 | No | HL, STS, bone | 16 |
| Skin (BCC) | 179 | 1.09** (0.49–2.64) | < .001 | No | HL, leukemia | 18 |
| Salivary glands |
20 | 0.36‖ (0.06–2.50) | .005 | No | Leukemia, HL, NHL |
17 |
Abbreviations: BCC=basal cell carcinoma, CI=confidence interval, Gy=gray, CNS=central nervous system, ERR=excess relative risk; HL=Hodgkin lymphoma, NHL=non-Hodgkin lymphoma;STS=soft tissue sarcoma
P-value is for contrast of linear dose-response model with null model, except for thyroid cancer for which the P-value is for a contrast of a linear-exponential-quadratic model with a model that includes only the linear term.
Adjusted for age at first cancer diagnosis, time since first cancer diagnosis, and gender. ERR/Gy is averaged over all ages at exposure.
Adjusted for age at first cancer diagnosis and time since first cancer diagnosis. ERR/Gy is averaged over all ages at exposure.
Adjusted for attained age, gender and type of first cancer. ERR/Gy is for the linear term in a linear-exponential-quadratic model [(β1D) exp(β4D2)] (Bhatti et al. 2010); P-value is for a contrast of a linear-exponential-quadratic model with a model that includes only the linear term. ERR/Gy is averaged over all ages at exposure.
Adjusted for age at first cancer diagnosis, time since first cancer diagnosis, sex, any anthracyclines, any chemotherapy and type of first cancer.
Adjusted for age at first cancer diagnosis, time since first cancer diagnosis, gender, race, HL as first cancer diagnosis, and calendar year of first cancer diagnosis
Adjusted for attained age, gender, race and attained calendar period.