Increased Cardiac Risk After a Second Malignant Neoplasm Among Childhood Cancer Survivors, a FCCSS Study
Résumé
BACKGROUND Advances in cancer treatment have significantly improved childhood cancer survival, with five-year survival exceeding 80% in most European and North American countries today. The adult population of childhood cancer survivors (CCS) exceeds 300,000 people in the USA alone, and is growing. Many late-effects have been observed at a higher rate than the general population. Cardiac disease (CD) and second malignant neoplasms (SMN) are among the most serious and life-threatening late adverse effects experienced by CCS. Previous work has identified important risk factors of CD, but the impact of other late-effects as SMN have been ignored. We have studied the effect of a SMN on both the cumulative incidence and the instantaneous risk of CD accounting for the competing risk of death.
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