title: Younger age distribution of cervical cancer incidence among survivors of pediatric and young adult cancers.
abstract: BACKGROUND
  Pediatric and young adult (PAYA) cancer survivors may have an earlier onset of chronic diseases compared with the general population. We compared the age at cervical cancer diagnosis between PAYA cancer survivors and females in the general US population.
  
  
  METHODS
  We used longitudinal data from 9 population-based registries of the Surveillance, Epidemiology, and End Results program collected between 1973 and 2010. PAYA cancer survivors were females diagnosed with any cancer before age 30 years, survived at least 5 years post-diagnosis, and were subsequently diagnosed with invasive cervical cancer (n=46). The general US population comprised females who were diagnosed with invasive cervical cancer as the primary malignancy (n=26,956). We estimated the difference in median age at diagnosis (ß₅₀) and bootstrap 95% confidence limits (CL) of invasive cervical cancer after adjustment for year of diagnosis and race.
  
  
  RESULTS
  The median age at diagnosis of invasive cervical cancer was 33 years for female PAYA cancer survivors and 40 years for females in the general US population (ß50=-7.0, 95% CL: -11, -3.2). Similar differences were observed across subgroups of stage and histologic subtype of invasive cervical cancer.
  
  
  CONCLUSIONS
  Our results suggest that PAYA cancer survivors are diagnosed with invasive cervical cancer at a substantially younger age compared with females without a prior cancer diagnosis in the general US population. This issue warrants further study, and could have implications for determining age at initiation or frequency of cervical cancer screening if younger age at diagnosis is attributable to an underlying biological phenomenon.
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA. Electronic address: rohit.ojha@stjude.org.
authors.forename: Rohit P
authors.initials: RP
authors.lastname: Ojha
authors.affiliation: Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Bradford E
authors.initials: BE
authors.lastname: Jackson
authors.affiliation: Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Tota
authors.affiliation: Data and Informatics Section, Delaware Health and Social Services, Dover, DE, USA.
authors.forename: Tabatha N
authors.initials: TN
authors.lastname: Offutt-Powell
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA; School of Public Health, University of Memphis, Memphis, TN, USA.
authors.forename: James G
authors.initials: JG
authors.lastname: Gurney
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D017741:Survivors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology*; D055815:Young Adult
keywords: Adolescent and young adult cancer; Aging; Cervical cancer; Pediatric cancer; Survivorship