Children who survive cancer are more likely to develop another tumour later in life.
Researchers followed 17,981 cancer survivors in America who were first diagnosed before the age of 15 over the last 25 years. During this period, 1,354 new tumours were found in 1,222 of the survivors. The most common tumours involved the central nervous system, followed by non-melanoma skin cancer.
Overall, the survivors were four times more likely than expected to develop another tumour later in life. In adults older than 40 years, the greatest additional risk was for a new tumour - either malignant or benign - of the digestive, genital or urinary tract organs.
Survivors were more likely to develop a subsequent tumour as they grew older - from 1.6 percent at age 20 to 13.8 percent at age 60 years, compared to just 8.4 percent of 60-year-olds in the general population.
The survivors were also at risk of developing a tumour at younger ages. By 38 years of age, 5 percent of the childhood cancer survivors had developed a new tumour. For the general population it would take until age 54 years for 5 percent to them develop a tumour.
The researchers also found that 1.4 percent of those studied whose childhood cancer was treated with direct irradiation near their abdominal and pelvic region developed colorectal cancer by the time they were 50 years old - roughly the same risk as people who have at least two first-degree relatives with this disease.
The risks of digestive subsequent tumours are likely to be related to previous exposure of the digestive tract to radiation, according to the researchers. They concluded there may be a need for childhood cancer survivors treated with direct abdomino-pelvic irradiation to be considered for routine colonoscopy screening for colorectal cancer. However, genetic predisposition is also at least partly to blame for the added tumour risk in childhood cancer survivors.
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