Risk of Leukemia Among Survivors of Testicular Cancer: A Population-based Study of 42,722 Patients

Regan Howard; Ethel Gilbert; Charles F Lynch; Per Hall; Hans Storm; Eric Holowaty; Eero Pukkala; Froydis Langmark; Magnus Kaijser; Michael Andersson; Heikki Joensuu; Sophie D Fossa; James M Allan; Lois B Travis

doi:10.1016/j.annepidem.2008.01.003

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Risk of Leukemia Among Survivors of Testicular Cancer: A Population-based Study of 42,722 Patients

Journal article

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Risk of Leukemia Among Survivors of Testicular Cancer: A Population-based Study of 42,722 Patients

Regan Howard, Ethel Gilbert, Charles F Lynch, Per Hall, Hans Storm, Eric Holowaty, Eero Pukkala, Froydis Langmark, Magnus Kaijser, Michael Andersson, …

Annals of epidemiology, Vol.18(5), pp.416-421

2008

DOI: 10.1016/j.annepidem.2008.01.003

PMCID: PMC4034178

PMID: 18433667

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Abstract

The aim of this study is to quantify excess absolute risk (EAR) and excess relative risk (ERR) of secondary leukemia among a large population-based group of testicular cancer survivors. We identified 42,722 1-year survivors of testicular cancer within 14 population-based cancer registries in Europe and North America (1943–2002). Poisson regression analysis was used to model EAR (per 100,000 person-years [PY]) and ERR of secondary leukemia. Cumulative risks were calculated using a competing risk model. Secondary leukemia developed in 89 patients (EAR = 10.8 per 100,000 PY, 95% confidence interval [CI] = 7.6–14.6; ERR = 1.6, 95%CI = 1.0–2.2). Statistically significantly elevated risks were observed for acute myeloid leukemia (AML) (EAR = 7.2, 95%CI = 4.7–10.2) and acute lymphoblastic leukemia (EAR = 1.3, 95%CI = 0.4–2.8). In multivariate analyses, AML risk was higher among patients whose initial management included chemotherapy compared to those receiving radiotherapy alone ( p = 0.1). Excess cumulative leukemia risk was approximately 0.23% by 30 years after testicular cancer diagnosis. Although ERR of leukemia following testicular cancer is large, EAR and cumulative risk, which are better gauges of the population burden, are small.

Leukemia

Second Primary Neoplasms

Testicular Neoplasms

Cohort Studies

Details

Title: Subtitle: Risk of Leukemia Among Survivors of Testicular Cancer: A Population-based Study of 42,722 Patients
Creators: Regan Howard - National Institutes of Health
Ethel Gilbert - Division of Cancer Epidemiology and Genetics; National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, MD
Charles F Lynch - State Health Registry of Iowa, Iowa City, IA
Per Hall - Karolinska Institutet, Stockholm, Sweden
Hans Storm - Danish Cancer Society, Copenhagen, Denmark
Eric Holowaty - Cancer Care Ontario, Toronto, Canada
Eero Pukkala - The Finnish Cancer Registry, Helsinki, Finland
Froydis Langmark - The Norwegian Cancer Registry, Oslo, Norway
Magnus Kaijser - Karolinska Institutet, Stockholm, Sweden
Michael Andersson - Danish Cancer Society, Copenhagen, Denmark
Heikki Joensuu - Helsinki University Central Hospital, Helsinki, Finland
Sophie D Fossa - Norwegian Radium Hospital, Oslo, Norway
James M Allan - Newcastle University, Newcastle upon Tyne, UK
Lois B Travis - Division of Cancer Epidemiology and Genetics; National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, MD
Resource Type: Journal article
Publication Details: Annals of epidemiology, Vol.18(5), pp.416-421
DOI: 10.1016/j.annepidem.2008.01.003
PMID: 18433667
PMCID: PMC4034178
NLM abbreviation: Ann Epidemiol
ISSN: 1047-2797
eISSN: 1873-2585
Publisher: Elsevier Inc
Language: English
Date published: 2008
Academic Unit: Epidemiology
Record Identifier: 9983995103802771

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