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Incidence of cancer in adolescent idiopathic scoliosis patients treated 25 years previously

European Spine Journal volume 25, pages 3366–3370 (2016)Cite this article

Abstract

Purpose

To report the incidence of cancer in a cohort of adolescent idiopathic scoliosis (AIS) patients treated 25 years previously.

Methods

215 consecutive AIS patients treated between 1983 and 1990 were identified and requested to return for clinical and radiographic examination. The incidence of cancer was determined through chart review and follow-up interviews. Using the original radiographic log file that included patient position, mAs, kV and the total number of X-rays taken, a radiation physicist calculated the total radiation dose during treatment and follow-up adjusted for BMI and sex.

Results

From the original cohort of 215 consecutive AIS patients, radiation information was available in 211 of the patients, and medical charts were available in 209 AIS patients. 170 (83 %) of the 205 AIS patients participated in the follow-up study with questionnaires. The calculated mean total radiation exposure was 0.8–1.4 mSV per examination and 2.4–5.6 mSv/year. An average of 16 radiographs were taken during the treatment period. Nine AIS patients developed cancer, mostly breast (3) and endometrial (4). The AIS patients had a relative risk of 4.8 (CI 2.3–5.8, p < 0.000) for developing cancer compared to the normal Danish population.

Conclusions

The overall cancer rate in this AIS cohort was 4.3 % which is five times higher than compared to the age-matched Danish population, and endometrial and breast cancer was most frequent. The radiation dose applied to the patients in this study, is comparable to modern equipment. This is to our knowledge the first study to report increased rates of endometrial cancers in a cohort of AIS patients, and future attention is needed to reduce the radiation dose distributed to the AIS patients both pre-operatively and during surgery.

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Authors and Affiliations

  1. Center for Spine Surgery and Research, Lillebaelt Hospital, Ostre Hougvej 55, 5500, Middelfart, Denmark

    Ane Simony, Emil Jesper Hansen, Steen Bach Christensen, Leah Y. Carreon & Mikkel Osterheden Andersen

  2. Department of Orthopaedic Surgery, University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Steen Bach Christensen

Authors
  1. Ane Simony
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  2. Emil Jesper Hansen
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  3. Steen Bach Christensen
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  4. Leah Y. Carreon
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  5. Mikkel Osterheden Andersen
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Corresponding author

Correspondence to Ane Simony.

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Conflict of interest

None of the authors has any potential conflict of interest.

This study was approved by the Ethical Committee of Southern Denmark, Datatilsynet, and was conducted at the Center for Spine Surgery and Research, Lillebaelt Hospital, Ostre Hougvej 55, 5000 Middelfart, Denmark.

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Simony, A., Hansen, E.J., Christensen, S.B. et al. Incidence of cancer in adolescent idiopathic scoliosis patients treated 25 years previously. Eur Spine J 25, 3366–3370 (2016). https://doi.org/10.1007/s00586-016-4747-2

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  • DOI: https://doi.org/10.1007/s00586-016-4747-2

Keywords

  • Adolescent idiopathic scoliosis
  • Long-term follow-up
  • Incidence of cancer
  • Radiation dose