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Screening and surveillance for second malignant neoplasms in adult survivors of childhood cancer: a report from the childhood cancer survivor study.

Publication ,  Journal Article
Nathan, PC; Ness, KK; Mahoney, MC; Li, Z; Hudson, MM; Ford, JS; Landier, W; Stovall, M; Armstrong, GT; Henderson, TO; Robison, LL; Oeffinger, KC
Published in: Ann Intern Med
October 5, 2010

BACKGROUND: Survivors of childhood cancer may develop a second malignant neoplasm during adulthood and therefore require regular surveillance. OBJECTIVE: To examine adherence to population cancer screening guidelines by survivors at average risk for a second malignant neoplasm and adherence to cancer surveillance guidelines by survivors at high risk for a second malignant neoplasm. DESIGN: Retrospective cohort study. SETTING: The Childhood Cancer Survivor Study (CCSS), a 26-center study of long-term survivors of childhood cancer that was diagnosed between 1970 and 1986. PATIENTS: 4329 male and 4018 female survivors of childhood cancer who completed a CCSS questionnaire assessing screening and surveillance for new cases of cancer. MEASUREMENTS: Patient-reported receipt and timing of mammography, Papanicolaou smear, colonoscopy, or skin examination was categorized as adherent to the U.S. Preventive Services Task Force guidelines for survivors at average risk for breast or cervical cancer or the Children's Oncology Group guidelines for survivors at high risk for breast, colorectal, or skin cancer as a result of cancer therapy. RESULTS: In average-risk female survivors, 2743 of 3392 (80.9%) reported having a Papanicolaou smear within the recommended period, and 140 of 209 (67.0%) reported mammography within the recommended period. In high-risk survivors, rates of recommended mammography among women were only 241 of 522 (46.2%) and the rates of colonoscopy and complete skin examinations among both sexes were 91 of 794 (11.5%) and 1290 of 4850 (26.6%), respectively. LIMITATIONS: Data were self-reported. Participants in the CCSS are a selected group of survivors, and their adherence may not be representative of all survivors of childhood cancer. CONCLUSION: Female survivors at average risk for a second malignant neoplasm show reasonable rates of screening for cervical and breast cancer. However, surveillance for new cases of cancer is very low in survivors at the highest risk for colon, breast, or skin cancer, suggesting that survivors and their physicians need education about their risks and recommended surveillance. PRIMARY FUNDING SOURCE: The National Cancer Institute, National Institutes of Health, and the American Lebanese Syrian Associated Charities.

Duke Scholars

Published In

Ann Intern Med

DOI

EISSN

1539-3704

Publication Date

October 5, 2010

Volume

153

Issue

7

Start / End Page

442 / 451

Location

United States

Related Subject Headings

  • Young Adult
  • Survivors
  • Skin Neoplasms
  • Risk Factors
  • Retrospective Studies
  • Patient Compliance
  • Neoplasms, Second Primary
  • Melanoma
  • Mass Screening
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Nathan, P. C., Ness, K. K., Mahoney, M. C., Li, Z., Hudson, M. M., Ford, J. S., … Oeffinger, K. C. (2010). Screening and surveillance for second malignant neoplasms in adult survivors of childhood cancer: a report from the childhood cancer survivor study. Ann Intern Med, 153(7), 442–451. https://doi.org/10.7326/0003-4819-153-7-201010050-00007
Nathan, Paul Craig, Kirsten Kimberlie Ness, Martin Christopher Mahoney, Zhenghong Li, Melissa Maria Hudson, Jennifer Sylene Ford, Wendy Landier, et al. “Screening and surveillance for second malignant neoplasms in adult survivors of childhood cancer: a report from the childhood cancer survivor study.Ann Intern Med 153, no. 7 (October 5, 2010): 442–51. https://doi.org/10.7326/0003-4819-153-7-201010050-00007.
Nathan PC, Ness KK, Mahoney MC, Li Z, Hudson MM, Ford JS, et al. Screening and surveillance for second malignant neoplasms in adult survivors of childhood cancer: a report from the childhood cancer survivor study. Ann Intern Med. 2010 Oct 5;153(7):442–51.
Nathan, Paul Craig, et al. “Screening and surveillance for second malignant neoplasms in adult survivors of childhood cancer: a report from the childhood cancer survivor study.Ann Intern Med, vol. 153, no. 7, Oct. 2010, pp. 442–51. Pubmed, doi:10.7326/0003-4819-153-7-201010050-00007.
Nathan PC, Ness KK, Mahoney MC, Li Z, Hudson MM, Ford JS, Landier W, Stovall M, Armstrong GT, Henderson TO, Robison LL, Oeffinger KC. Screening and surveillance for second malignant neoplasms in adult survivors of childhood cancer: a report from the childhood cancer survivor study. Ann Intern Med. 2010 Oct 5;153(7):442–451.

Published In

Ann Intern Med

DOI

EISSN

1539-3704

Publication Date

October 5, 2010

Volume

153

Issue

7

Start / End Page

442 / 451

Location

United States

Related Subject Headings

  • Young Adult
  • Survivors
  • Skin Neoplasms
  • Risk Factors
  • Retrospective Studies
  • Patient Compliance
  • Neoplasms, Second Primary
  • Melanoma
  • Mass Screening
  • Male