Absolute Risk Prediction of Second Primary Thyroid Cancer Among 5-Year Survivors of Childhood Cancer

• Type of Material: Article
• Authors: Stephanie A. Kovalchik, National Institutes of Health; Cecile M. Ronckers, Late Effects After Childhood Cancer Treatment; Lene H. S. Veiga, Brazilian Nuclear Energy Commission; Alice J. Sigurdson, National Institutes of Health; Peter D. Inskip, National Institutes of Health; Florent de Vathaire, National Institute of Health and Medical Research; Charles A. Sklar, Memorial Sloan Kettering Cancer Center; Sarah S. Donaldson, Stanford University; Harald Anderson, Lund University; Parveen Bhatti, Fred Hutchinson Cancer Research Center; Sue Hammond, Nationwide Children’s Hospital; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center; Ann Mertens, Emory University; Susan Smith, Emory University; Marilyn Stovall, University of Texas MD Anderson Cancer Center; Margaret A. Tucker, National Institutes of Health; Rita E. Weathers, University of Texas MD Anderson Cancer Center; Leslie L. Robison, St Jude Children's Research Hospital; Ruth M. Pfeiffer, National Cancer Institute
• Language: English
• Date: 2013-01-01
• Publisher: American Society of Clinical Oncology
• Publication Version: Final Published Version
• Copyright Statement: © 2012 by American Society of Clinical Oncology.
• Final Published Version (URL): http://dx.doi.org/10.1200/JCO.2012.41.8996
• Title of Journal or Parent Work: Journal of Clinical Oncology
• ISSN: 0732-183X
• Volume: 31
• Issue: 1
• Start Page: 119
• End Page: 127
• Grant/Funding Information: The Childhood Cancer Survivor Study was supported by Grant No. U24 CA55727 from the NCI (L.L.R.).; Supported by the Intramural Research Program of the National Cancer Institute (NCI), National Institutes of Health.
• Keywords: COHORT; RADIOTHERAPY; RADIATION; Life Sciences & Biomedicine; IRRADIATION; LATE MORTALITY; BREAST-CANCER; NEOPLASMS; POOLED ANALYSIS; MODELS; Science & Technology; Oncology; NORDIC COUNTRIES
• Research Categories: Health Sciences, Oncology

Abstract

Purpose: We developed three absolute risk models for second primary thyroid cancer to assist with long-term clinical monitoring of childhood cancer survivors. Patients and Methods: We used data from the Childhood Cancer Survivor Study (CCSS) and two nested case-control studies (Nordic CCSS; Late Effects Study Group). Model M1 included self-reported risk factors, model M2 added basic radiation and chemotherapy treatment information abstracted from medical records, and model M3 refined M2 by incorporating reconstructed radiation absorbed dose to the thyroid. All models were validated in an independent cohort of French childhood cancer survivors. Results: M1 included birth year, initial cancer type, age at diagnosis, sex, and past thyroid nodule diagnosis. M2 added radiation (yes/no), radiation to the neck (yes/no), and alkylating agent (yes/no). Past thyroid nodule was consistently the strongest risk factor (M1 relative risk [RR], 10.8; M2 RR, 6.8; M3 RR, 8.2). In the validation cohort, 20-year absolute risk predictions for second primary thyroid cancer ranged from 0.04% to 7.4% for M2. Expected events agreed well with observed events for each model, indicating good calibration. All models had good discriminatory ability (M1 area under the receiver operating characteristics curve [AUC], 0.71; 95% CI, 0.64 to 0.77; M2 AUC, 0.80; 95% CI, 0.73 to 0.86; M3 AUC, 0.75; 95% CI, 0.69 to 0.82). Conclusion: We developed and validated three absolute risk models for second primary thyroid cancer. Model M2, with basic prior treatment information, could be useful for monitoring thyroid cancer risk in childhood cancer survivors.