title: Growth hormone treatment and risk of second neoplasms in the childhood cancer survivor.
abstract: BACKGROUND
  GH deficiency is common in childhood cancer survivors. In a previous report, although we did not find an increase in the risk of disease recurrence in survivors treated with GH, GH-treated survivors did have an increased risk of developing a second neoplasm (SN) (rate ratio, 3.21).
  
  
  OBJECTIVE
  In this analysis, we have reassessed the risk of GH-treated survivors developing an SN after an additional 32 months of follow-up.
  
  
  METHODS
  We conducted a retrospective cohort multicenter study.
  
  
  METHODS
  Among a total of 14,108 survivors who were enrolled in the Childhood Cancer Survivor Study, a retrospective cohort of 5-yr survivors of childhood cancer, we identified 361 who were treated with GH.
  
  
  RESULTS
  We assessed the risk of developing an SN.
  
  
  RESULTS
  During the extended follow-up, five new SN developed in survivors treated with GH, for a total of 20 SN, all solid tumors. Using a time-dependent Cox model, the rate ratio of GH-treated survivors developing an SN, compared with non-GH-treated survivors, was 2.15 (95% confidence interval, 1.3-3.5; P < 0.002). Meningiomas were the most common SN (n = 9) among the GH-treated group.
  
  
  CONCLUSIONS
  Although cancer survivors treated with GH appear to have an increased risk of developing SN compared with survivors not so treated, the elevation of risk due to GH use appears to diminish with increasing length of follow-up. Continued surveillance is essential.
authors.affiliation: Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York, 10021, USA.
authors.forename: Berrin
authors.initials: B
authors.lastname: Ergun-Longmire
authors.forename: Ann C
authors.initials: AC
authors.lastname: Mertens
authors.forename: Pauline
authors.initials: P
authors.lastname: Mitby
authors.forename: Jing
authors.initials: J
authors.lastname: Qin
authors.forename: Glenn
authors.initials: G
authors.lastname: Heller
authors.forename: Weiji
authors.initials: W
authors.lastname: Shi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yasui
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.forename: Charles A
authors.initials: CA
authors.lastname: Sklar
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D016609:Neoplasms, Second Primary / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires
chemical_list: D019382:Human Growth Hormone