title: Risk of second malignant neoplasms after childhood central nervous system malignant tumours: an international study.
abstract: OBJECTIVE
  The aim of this study was to assess the risk of second malignant neoplasms (SMNs) other than central nervous system (CNS) neoplasms after childhood CNS cancer in an international multicentre study.
  
  
  METHODS
  Individual data on cases of CNS cancer in children (0-14 years) and on subsequent SMNs were obtained from 13 population-based cancer registries contributing data for different time periods in 1943-2000. Standardised incidence ratios (SIRs) with 95% confidence intervals (CI), absolute excess risk and cumulative incidence of SMNs were computed.
  
  
  RESULTS
  We observed 43 SMNs in 8431 CNS cancer survivors. The SIR was 10.6 (4.85-20.1) for thyroid cancer (nine cases), 2.75 (1.01-5.99) for leukaemia (six cases) and 2.47 (0.90-5.37) for lymphoma (six cases). The SIRs were highest in the first 10 years after CNS cancer diagnosis. The cumulative incidence of non-CNS SMNs was 3.30% (0.95-5.65%) within 45 years after a CNS cancer diagnosis. Within 15 years, the cumulative incidence was highest for cases diagnosed after 1980 (0.56%, 95% CI: 0.29-0.82%).
  
  
  CONCLUSIONS
  This population-based study indicates that about one every 180 survivors of a childhood CNS cancer will develop a non-CNS SMN within the following 15 years. The excess is higher after glioma and embryonal malignant tumour than after another CNS tumour.
authors.affiliation: Childhood Cancer Registry of Piedmont, Cancer Epidemiology Unit, CPO Piemonte, CeRMS, University of Turin, Turin, Italy. milena.maule@cpo.it
authors.forename: M
authors.initials: M
authors.lastname: Maule
authors.forename: G
authors.initials: G
authors.lastname: Scélo
authors.forename: G
authors.initials: G
authors.lastname: Pastore
authors.forename: P
authors.initials: P
authors.lastname: Brennan
authors.forename: K
authors.initials: K
authors.lastname: Hemminki
authors.forename: E
authors.initials: E
authors.lastname: Pukkala
authors.forename: E
authors.initials: E
authors.lastname: Weiderpass
authors.forename: J H
authors.initials: JH
authors.lastname: Olsen
authors.forename: E
authors.initials: E
authors.lastname: Tracey
authors.forename: M L
authors.initials: ML
authors.lastname: McBride
authors.forename: D H
authors.initials: DH
authors.lastname: Brewster
authors.forename: V
authors.initials: V
authors.lastname: Pompe-Kirn
authors.forename: J M
authors.initials: JM
authors.lastname: Tonita
authors.forename: E V
authors.initials: EV
authors.lastname: Kliewer
authors.forename: K S
authors.initials: KS
authors.lastname: Chia
authors.forename: J G
authors.initials: JG
authors.lastname: Jonasson
authors.forename: C
authors.initials: C
authors.lastname: Martos
authors.forename: C
authors.initials: C
authors.lastname: Magnani
authors.forename: P
authors.initials: P
authors.lastname: Boffetta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016543:Central Nervous System Neoplasms / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D012306:Risk