The Time Has Come to Enhance Skin Cancer Screening for Adult Childhood Cancer Survivors
Menée aux Pays-Bas à partir de donnnées portant sur 5 843 patients ayant survécu au moins 5 ans à un cancer pédiatrique diagnostiqué entre 1963 et 2011, cette étude de cohorte analyse le risque à long terme de développer un cancer de la peau, en lien avec les traitements anticancéreux reçus (radiothérapie et chimiothérapie)
There are estimated to be over 420 000 adult childhood cancer survivors in the United States (1) alone. Advances in the diagnosis and treatment of children with cancer have contributed to an overall 5-year survival rate that currently exceeds 80% (2). However, an increased risk for subsequent neoplasms such as skin cancers that frequently occur within the radiation field is one of the late effects of childhood cancer treatment (3). Skin cancers, primarily basal cell carcinomas (BCCs), are the most common subsequent neoplasm, representing an estimated 58% of later cancers (4).BCCs are very rare events for young people in the general population. In contrast, young survivors, primarily treated with radiation, face an epidemic proportion of skin cancer, primarily BCCs. In this study of 5843 Dutch survivors, Teepen et al. document standardized incidence ratios of 29.8 for basal cell cancer, 2.3 for melanoma, and 7.5 for squamous cell cancer (5). The median age of the sample was only 30.6 years. Strikingly, nearly 50% of those who had a first BCC had more BCCs later, averaging 4.1 BCCs per individual (5) Furthermore, BCC risk was elevated when increasing skin surface area WAS exposed to radiation (5).
Journal of the National Cancer Institute , commentaire en libre accès, 2018