Christina NMSC data

Background: Childhood cancer survivors (CCS) are at increased risk for keratinocyte carcinomas (KC) however, the long-term incidence of single and multiple KC is not well established. Objective: Identify risk factors and quantify KC cumulative incidence and multiple-incidence burden in CCS. Methods: KC were identified among Childhood Cancer Survivor Study participants, a cohort of five-year cancer survivors diagnosed <21 years of age between 1970-1999 in North America. Cumulative incidence was estimated, and multivariable models assessed relative rates of KC associated with survivor and treatment characteristics. Results: Among 25,658 participants, 1,446 developed 5,363 KC (93.5% basal cell carcinoma, 6.7% squamous cell carcinoma; mean age 37.0 years (range 7.3-67.4), mean latency 25.7 years; 95.3% White and 88.4% with radiotherapy [RT]). Mean lesion count was 3.7 with 26.1% experiencing 4. RT imparted a 4.5-fold increase in the rate of any KC and 9.4-fold increase in the rate of 4 KC. Allogeneic and autologous hematopoietic cell transplant were associated with a 3.4- and 2.3-fold increased rate of KC, respectively.研究背景：儿童癌症幸存者（Childhood Cancer Survivors, CCS）罹患角质形成细胞癌（keratinocyte carcinomas, KC）的风险显著升高，但目前对于单发及多发KC的长期发病率仍尚不明确。 研究目的：明确CCS人群中KC的相关危险因素，并量化其累积发病率与多发KC的疾病负担。 研究方法：本研究在儿童癌症幸存者研究（Childhood Cancer Survivor Study, CCSS）队列中筛选KC病例。该队列纳入了1970年至1999年间于北美地区确诊、确诊时年龄小于21岁且生存期已满5年的癌症幸存者。研究人员估算了KC的累积发病率，并通过多变量模型评估了幸存者自身特征及治疗相关因素与KC相对发病风险的关联。 研究结果：在25658名研究参与者中，共有1446人罹患5363例KC，其中93.5%为基底细胞癌，6.7%为鳞状细胞癌；受试者平均年龄为37.0岁（范围7.3~67.4岁），平均潜伏期为25.7年；95.3%的受试者为白人，88.4%接受过放射治疗（radiotherapy, RT）。受试者的平均皮损数量为3.7个，其中26.1%的患者出现≥4处皮损。放射治疗可使任意类型KC的发病风险升高4.5倍，使多发（≥4处）KC的发病风险升高9.4倍。异基因及自体造血干细胞移植分别可使KC的发病风险升高3.4倍与2.3倍。