Risk of leukemia among survivors of testicular cancer: a population-based study of 42,722 patients

R. Howard, E. Gilbert, C.F. Lynch, P. Hall, H. Storm, E. Holowaty, E. Pukkala, F. Langmark, M. Kaijser, M. Andersson, H. Joensuu, S.D. Fossa, J.M. Allan, L.B. Travis

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Abstract

PURPOSE: The aim of this study is to quantify excess absolute risk (EAR) and excess relative risk (ERR) of secondary leukemia among a large population-based group of testicular cancer survivors. METHODS: We identified 42,722 1-year survivors of testicular cancer within 14 population-based cancer registries in Europe and North America (1943-2002). Poisson regression analysis was used to model EAR (per 100,000 person-years [PY]) and ERR of secondary leukemia. Cumulative risks were calculated using a competing risk model. RESULTS: Secondary leukemia developed in 89 patients (EAR = 10.8 per 100,000 PY, 95% confidence interval [CI] = 7.6-14.6; ERR = 1.6, 95%CI = 1.0-2.2). Statistically significantly elevated risks were observed for acute myeloid leukemia (AML) (EAR = 7.2, 95%CI = 4.7-10.2) and acute lymphoblastic leukemia (EAR = 1.3, 95%CI = 0.4-2.8). In multivariate analyses, AML risk was higher among patients whose initial management included chemotherapy compared to those receiving radiotherapy alone (p = 0.1). Excess cumulative leukemia risk was approximately 0.23% by 30 years after testicular cancer diagnosis. CONCLUSIONS: Although ERR of leukemia following testicular cancer is large, EAR and cumulative risk, which are better gauges of the population burden, are small
Udgivelsesdato: 2008/5
OriginalsprogEngelsk
TidsskriftAnnals of Epidemiology
Vol/bind18
Udgave nummer5
Sider (fra-til)416-421
Antal sider5
ISSN1047-2797
StatusUdgivet - 2008

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