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A Methodological Issue in the Analysis of Second-Primary Cancer Incidence in Long-Term Survivors of Childhood Cancers

Yasui, Yutaka ; Liu, Yan ; Neglia, Joseph P. ; Friedman, Debra L. ; Bhatia, Smita ; Meadows, Anna T. ; Diller, Lisa R. ; Mertens, Ann C. ; Whitton, John ; Robison, Leslie L.

American journal of epidemiology, 2003-12, Vol.158 (11), p.1108-1113 [Periódico revisado por pares]

Cary, NC: Oxford University Press

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Título:
A Methodological Issue in the Analysis of Second-Primary Cancer Incidence in Long-Term Survivors of Childhood Cancers
Autor: Yasui, Yutaka ; Liu, Yan ; Neglia, Joseph P. ; Friedman, Debra L. ; Bhatia, Smita ; Meadows, Anna T. ; Diller, Lisa R. ; Mertens, Ann C. ; Whitton, John ; Robison, Leslie L.
Assuntos: Adolescent ; Adult ; Age Distribution ; age factors ; Aged ; Analysis. Health state ; and End Results ; Biological and medical sciences ; Breast Neoplasms - epidemiology ; CCSS ; Child ; Child, Preschool ; Childhood Cancer Survivor Study ; cohort studies ; confidence interval ; epidemiologic methods ; Epidemiology ; Female ; General aspects ; Humans ; Incidence ; Late Effects Study Group ; LESG ; Medical sciences ; Middle Aged ; neoplasms ; Neoplasms, Second Primary - epidemiology ; Proportional Hazards Models ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; second primary ; second-primary malignant neoplasm ; SEER ; SEER Program ; SMN ; statistical ; Surveillance ; United States - epidemiology
É parte de: American journal of epidemiology, 2003-12, Vol.158 (11), p.1108-1113
Notas: istex:8C95E925D1C03869711E4D94993BFED855FCAD0A
local:kwg278
ark:/67375/HXZ-16VRCC3N-3
Received for publication March 4, 2003; accepted for publication June 18, 2003.
ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: Survival of childhood cancer patients has increased remarkably in the last several decades due to therapeutic improvements. Associated with this progress is the emerging need to accurately assess/minimize late effects of cancer therapy in long-term survivors. This paper considers a methodological issue in assessing the risk of second-primary malignant neoplasms, a major late effect of concern, using second-primary female breast cancer as an example. In the assessment of second-primary malignant neoplasm risk, attained age is a critical factor that must be taken into account. Even with follow-up of decades, childhood-cancer survivors are still at relatively young ages for developing adult-onset diseases. Attained ages at follow-up, however, modify cancer risk considerably; for example, in the general population, women aged 40 years have about fivefold increased breast cancer risk compared with women aged 30 years. A failure to account for the natural age-associated increase of risk could alter, or even reverse, analytical conclusions. This problem was studied empirically by both descriptive and regression analyses of two major studies of long-term childhood-cancer survivors, the Childhood Cancer Survivor Study (1975–1999) and the Late Effects Study Group (1955–1994). These showed appreciable differences in the analytical results by not accounting for the natural age-associated increase of risk, illustrating a significant impact of this methodological issue on study conclusions.
Editor: Cary, NC: Oxford University Press
Idioma: Inglês

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A Methodological Issue in the Analysis of Second-Primary Cancer Incidence in Long-Term Survivors of Childhood Cancers

Yasui, Yutaka ; Liu, Yan ; Neglia, Joseph P. ; Friedman, Debra L. ; Bhatia, Smita ; Meadows, Anna T. ; Diller, Lisa R. ; Mertens, Ann C. ; Whitton, John ; Robison, Leslie L.

Cary, NC: Oxford University Press

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