Risk of subsequent primary neoplasms in survivors of adolescent and young adult cancer (Teenage and Young Adult Cancer Survivor Study): a population-based, cohort study

Bright, Chloe J; Reulen, Raoul C.; Winter, D.; Stark, Daniel P.; McCabe, Martin G.; Edgar, Angela B; Frobisher, Clare; Hawkins, Michael M.

doi:10.1016/s1470-2045(18)30903-3

Cited by 114 publications

(107 citation statements)

References 36 publications

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“…This is a far greater variation compared to that seen in AYA in the TYACSS where the SIRs varied from 1.1 for breast SPNs to 3.0 for meningiomas . Similarly, if we compare the SIRs for breast cancer after Hodgkin lymphoma in female survivors, the estimate in the BCCSS was 8.9, over twice as high as the corresponding estimate in the TYACSS (SIR = 3.2) . There are a number of factors that may be related to these differences, including the potential for greater toxicity in tissue and organs exposed to cancer treatments whilst still developing and the different spectrum of malignant diseases predominating in childhood and AYA and the consequent different treatment exposures.…”

Section: Risks Of Adverse Physical Outcomes In Survivors Of Aya Cancermentioning

confidence: 84%

“…For example, if we compare the SPN‐specific risks in two United Kingdom population‐based studies – the British Childhood Cancer Survivor Study (BCCSS) and the Teenage and Young Adult Cancer Survivor Study (TYACSS) – we observe SIRs varying from 1.9 for genitourinary SPNs to 30.5 for bone SPNs in the BCCSS . This is a far greater variation compared to that seen in AYA in the TYACSS where the SIRs varied from 1.1 for breast SPNs to 3.0 for meningiomas . Similarly, if we compare the SIRs for breast cancer after Hodgkin lymphoma in female survivors, the estimate in the BCCSS was 8.9, over twice as high as the corresponding estimate in the TYACSS (SIR = 3.2) .…”

Section: Risks Of Adverse Physical Outcomes In Survivors Of Aya Cancermentioning

confidence: 96%

“…Given the potential role of lifestyle factors in the excess risk of strokes and SPNs reported among survivors of AYA cancer, further clarification is needed for the extent to which lifestyle factors are involved in the development of these outcomes and which interventions could target lifestyle factors with the strongest effect.…”

Section: Intervention Studies Aimed At Prevention Earlier Diagnosis mentioning

confidence: 99%

“…Compared to research in children, the vast majority of studies in AYA have focused on specific diagnosis groups, such as testicular cancer, 16,17 breast cancer [18][19][20][21][22] and Hodgkin lymphoma. [23][24][25] Only two studies 26,27 have addressed the risk of SPNs after each AYA cancer diagnosis, and only the former assessed the risks of specific types of SPNs after each particular AYA cancer.…”

Section: Subsequent Primary Neoplasmsmentioning

confidence: 99%

“…While the SPN standardised incidence ratios (SIRs) in children range from three-to sixfold of that expected, [27][28][29][30][31][32][33][34][35] 26,28 There are a number of factors that may be related to these differences, including the potential for greater toxicity in tissue and organs exposed to cancer treatments whilst still developing and the different spectrum of malignant diseases predominating in childhood and AYA and the consequent different treatment exposures.…”

Section: Subsequent Primary Neoplasmsmentioning

confidence: 99%

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Challenges and opportunities in the care of survivors of adolescent and young adult cancers

Fidler

Frobisher

Hawkins

et al. 2019

Pediatric Blood & Cancer

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Adolescents and young adults (AYA) with cancer are an understudied group. Much of what is known about long‐term outcomes after AYA cancer has been derived from cohorts of childhood cancer survivors, which seldom include patients at the older end of the AYA age spectrum. In general, AYA cancer survivors have a lower risk for premature mortality, subsequent primary neoplasms and chronic health conditions than childhood cancer survivors. However, AYA cancer survivors are vulnerable to psychosocial challenges, concerns about fertility and relationships and financial toxicity. No single model is optimal for the care of these survivors, but it is generally agreed that all survivors require a survivor care plan that promotes their adherence to evidence‐based surveillance guidelines. There is a need to create survivor cohorts that include the full range of AYA ages and diagnoses to be able to address the many pressing questions that remain unanswered in this vulnerable population.

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Section: Risks Of Adverse Physical Outcomes In Survivors Of Aya Cancermentioning

confidence: 84%

Section: Risks Of Adverse Physical Outcomes In Survivors Of Aya Cancermentioning

confidence: 96%

Section: Intervention Studies Aimed At Prevention Earlier Diagnosis mentioning

confidence: 99%

Section: Subsequent Primary Neoplasmsmentioning

confidence: 99%

Section: Subsequent Primary Neoplasmsmentioning

confidence: 99%

See 3 more Smart Citations

Challenges and opportunities in the care of survivors of adolescent and young adult cancers

Fidler

Frobisher

Hawkins

et al. 2019

Pediatric Blood & Cancer

Self Cite

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Association of First Primary Cancer With Risk of Subsequent Primary Cancer Among Survivors of Adult-Onset Cancers in the United States

Sung

Hyun

Leach

et al. 2020

JAMA

137

143

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The number of cancer survivors who develop new cancers is projected to increase, but comprehensive data on the risk of subsequent primary cancers (SPCs) among survivors of adult-onset cancers are limited.OBJECTIVE To quantify the overall and cancer type-specific risks of SPCs among adult-onset cancer survivors by first primary cancer (FPC) types and sex. DESIGN, SETTING, AND PARTICIPANTSA retrospective cohort study from 12 Surveillance, Epidemiology, and End Results registries in the United States, that included 1 537 101 persons aged 20 to 84 years diagnosed with FPCs from 1992-2011 (followed up until December 31, 2017) and who survived at least 5 years.EXPOSURES First primary cancer. MAIN OUTCOMES AND MEASURESIncidence and mortality of SPCs per 10 000 person-years; standardized incidence ratio (SIR) and standardized mortality ratio (SMR) compared with those expected in the general population.RESULTS Among 1 537 101 survivors (mean age, 60.4 years; 48.8% women), 156 442 SPC cases and 88 818 SPC deaths occurred during 11 197 890 person-years of follow-up (mean, 7.3 years). Among men, the overall risk of developing any SPCs was statistically significantly higher for 18 of the 30 FPC types, and risk of dying from any SPCs was statistically significantly higher for 27 of 30 FPC types as compared with risks in the general population. Among women, the overall risk of developing any SPCs was statistically significantly higher for 21 of the 31 FPC types, and risk of dying from any SPCs was statistically significantly higher for 28 of 31 FPC types as compared with risks in the general population. The highest overall SIR and SMR were estimated among survivors of laryngeal cancer (SIR, 1.75 [95% CI, 1.68-1.83]; incidence, 373 per 10 000 person-years) and gallbladder cancer (SMR, 3.82 [95% CI,; mortality, 341 per 10 000 person-years) among men, and among survivors of laryngeal cancer (SIR, 2.48 [95% CI, 2.27-2.72]; incidence, 336 per 10 000 person-years; SMR, 4.56 [95% CI,; mortality, 268 per 10 000 person-years) among women. Substantial variation existed in the associations of specific types of FPCs with specific types of SPC risk; however, only a few smoking-or obesity-associated SPCs, such as lung, urinary bladder, oral cavity/pharynx, colorectal, pancreatic, uterine corpus, and liver cancers constituted considerable proportions of the total incidence and mortality, with lung cancer alone accounting for 31% to 33% of mortality from all SPCs.CONCLUSIONS AND RELEVANCE Among survivors of adult-onset cancers in the United States, several types of primary cancer were significantly associated with greater risk of developing and dying from an SPC, compared with the general population. Cancers associated with smoking or obesity comprised substantial proportions of overall SPC incidence and mortality among all survivors and highlight the importance of ongoing surveillance and efforts to prevent new cancers among survivors.

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A Mobile Instant Messaging–Delivered Psychoeducational Intervention for Cancer Caregivers

Cheng,

Ng,

Choi

et al. 2024

JAMA Netw Open

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ImportancePsychoeducational interventions (PEIs), which provide both information and emotional and psychosocial support, may address the unmet needs of the caregivers of adolescent and young adult patients with cancer.ObjectiveTo explore the effects of an instant messaging–delivered PEI on anxiety, depression, quality of life (QOL), and coping and determine whether the intervention reduces caregivers’ unmet needs.Design, Setting, and ParticipantsThis randomized clinical trial using an intention-to-treat protocol was conducted from April 1 to September 14, 2022, in a tertiary cancer hospital in China and included caregivers of patients diagnosed with cancer at age 15 to 39 years recruited using convenience sampling.InterventionCaregivers were allocated 1:1 using a randomized block scheme to the intervention or control group. The intervention group received a 5-week PEI and usual care, whereas the control group received only usual care. The PEI was delivered through articles and calls through an instant messaging application.Main Outcomes and MeasuresThe primary outcomes were changes in the levels of caregivers’ anxiety and depression, measured using the 7-Item Generalized Anxiety Disorder Scale and the Patient Health Questionnaire 9, respectively. The secondary outcomes were changes in the levels of caregivers’ QOL, coping, and unmet needs.ResultsOf the 160 participants, 92 (57.5%) were male; mean (SD) age was 40.27 (8.33) years. Compared with the control group, the intervention group had significantly greater reduction in severity of anxiety (B = −3.231; 95% CI, −4.746 to −1.716; P &lt; .001) and depression (B = −3.253; 95% CI, −5.052 to −1.454; P &lt; .001), smaller reduction in QOL (B = 13.574; 95% CI, 0.488-26.661; P = .04), and greater reduction in unmet needs (B = −12.136; 95% CI, −18.307 to −5.965; P &lt; .001) after the intervention. Twelve weeks after baseline, the intervention group demonstrated a significantly greater reduction only in severity of anxiety (B = −1.890; 95% CI, −3.382 to −0.397; P = .01).Conclusions and RelevanceIn this randomized clinical trial of a mobile instant messaging–delivered PEI, caregivers’ unmet needs, anxiety, and depression decreased significantly and QOL declined at a significantly slower rate immediately after the intervention in the intervention group compared with the control group. A sustained effect on anxiety was observed 12 weeks after baseline.Trial RegistrationChinese Clinical Trial Registry identifier: ChiCTR2200055951

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Risk of subsequent primary neoplasms in survivors of adolescent and young adult cancer (Teenage and Young Adult Cancer Survivor Study): a population-based, cohort study

Cited by 114 publications

References 36 publications

Challenges and opportunities in the care of survivors of adolescent and young adult cancers

Challenges and opportunities in the care of survivors of adolescent and young adult cancers

Association of First Primary Cancer With Risk of Subsequent Primary Cancer Among Survivors of Adult-Onset Cancers in the United States

A Mobile Instant Messaging–Delivered Psychoeducational Intervention for Cancer Caregivers

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