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Screening colonoscopy according to guidelines in long-term survivors of childhood cancer—results of a population-based study

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Abstract

Purpose

To report on findings in screening colonoscopies in long-term survivors of childhood cancer treated with abdominopelvic irradiation (RT).

Methods

Screening colonoscopies were introduced at the Slovenian outpatient follow-up clinic in 2015, according to the Children’s Oncology Group guidelines. In January 2019, 54 patients who received abdominopelvic irradiation for Hodgkin disease, Wilms tumour or dysgerminoma at the age of 0–16 between 1968 and 1995 were eligible for screening colonoscopy, and until December 2019, twenty-eight asymptomatic patients have undergone this examination.

Results

Patients were 1–16 (median 13) years old at cancer diagnosis and had colonoscopy 24–47 (median 36) years after diagnosis. They received abdominopelvic irradiation with the dose 16–46 (median 30) Gy. Adenomatous lesions were found in 18 patients (64%) and advanced adenomatous lesions in one-third. Patients who received abdominopelvic RT with a dose below 30 Gy had 75% incidence of adenomatous lesions and in those who received a dose of 30 Gy or more the incidence was 60%. Alkylating agents did not have impact on this incidence.

Conclusions

In this first population-based study of screening colonoscopies in asymptomatic survivors of childhood cancer, we provided new evidence for 64% incidence of adenomatous lesions after abdominopelvic RT with the dose above or below 30 Gy.

Implications for Cancer Survivors

Screening colonoscopies are of vital importance in patients treated with abdominal RT in childhood.

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References

  1. Sant M, Santaquilani M, Stiller C, Tavilla A, Trama A, Visser O, et al. Childhood cancer survival in Europe 1999-2007: results of EUROCARE-5--a population-based study. Lancet Oncol. 2014;15(1):35–47. https://doi.org/10.1016/S1470-2045(13)70548-5 Epub 2013 Dec 5. Erratum in: Lancet Oncol. 2014 Feb;15(2):e52. PMID: 24314616.

    Article  PubMed  Google Scholar 

  2. Pohar Perme M, Jereb B. Trends in survival after childhood cancer in Slovenia between 1957 and 2007. Pediatr Hematol Oncol. 2009;26(4):240–51. https://doi.org/10.1080/08880010902900437.

    Article  Google Scholar 

  3. Hjorth L, Haupt R, Skinner R, Grabow D, Byrne J, Karner S, et al. Survivorship after childhood cancer: PanCare: a European Network to promote optimal long-term care. Eur J Cancer. 2015;51(10):1203–11. https://doi.org/10.1016/j.ejca.2015.04.002.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Robertson CM, Hawkins MM, Kingston JE. Late deaths and survival after childhood cancer: implications for cure. BMJ. 1994;309(6948):162–6. https://doi.org/10.1136/bmj.309.6948.162.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Möller TR, Garwicz S, Barlow L, Winther JF, Glattre E, Olafsdottir G, et al. Association of the Nordic Cancer Registries; Nordic Society for Pediatric Hematology and Oncology. Decreasing late mortality among five-year survivors of cancer in childhood and adolescence: a population-based study in the Nordic countries. J Clin Oncol. 2001;19(13):3173–81. https://doi.org/10.1200/JCO.2001.19.13.3173.

    Article  PubMed  Google Scholar 

  6. Mertens AC. Cause of mortality in 5-year survivors of childhood cancer. Pediatr Blood Cancer. 2007;48(7):723–6. https://doi.org/10.1002/pbc.21114.

    Article  PubMed  Google Scholar 

  7. Mertens AC, Liu Q, Neglia JP, Wasilewski K, Leisenring W, Armstrong GT, et al. Cause-specific late mortality among 5-year survivors of childhood cancer: the childhood cancer survivor study. J Natl Cancer Inst. 2008;100(19):1368–79. https://doi.org/10.1093/jnci/djn310.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Reulen RC, Winter DL, Frobisher C, Lancashire ER, Stiller CA, Jenney ME. et al; British childhood cancer survivor study steering group. Long-term cause-specific mortality among survivors of childhood cancer. JAMA. 2010;304(2):172–9. https://doi.org/10.1001/jama.2010.923.

    Article  CAS  PubMed  Google Scholar 

  9. Li FP, Cassady JR, Jaffe N. Risk of second tumors in survivors of childhood cancer. Cancer. 1975;35(4):1230–5. https://doi.org/10.1016/0022-3468(76)90274-8.

    Article  CAS  PubMed  Google Scholar 

  10. Neglia JP, Friedman DL, Yasui Y, Mertens AC, Hammond S, Stovall M, et al. Second malignant neoplasms in five-year survivors of childhood cancer: childhood cancer survivor study. J Natl Cancer Inst. 2001;93(8):618–29. https://doi.org/10.1093/jnci/93.8.618.

    Article  CAS  PubMed  Google Scholar 

  11. Inskip PD, Curtis RE. New malignancies following childhood cancer in the United States, 1973-2002. Int J Cancer. 2007;121(10):2233–40. https://doi.org/10.1002/ijc.22827.

    Article  CAS  PubMed  Google Scholar 

  12. Olsen JH, Möller T, Anderson H, Langmark F, Sankila R, Tryggvadóttír L, et al. Lifelong cancer incidence in 47,697 patients treated for childhood cancer in the Nordic countries. J Natl Cancer Inst. 2009;101(11):806–13. https://doi.org/10.1093/jnci/djp104.

    Article  PubMed  Google Scholar 

  13. Friedman DL, Whitton J, Leisenring W, Hammond S, Stovall M, Donaldson SS, et al. Subsequent neoplasms in 5-year survivors of childhood cancer: the childhood cancer survivor study. J Natl Cancer Inst. 2010;102(14):1083–95. https://doi.org/10.1093/jnci/djq238.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Reulen RC, Frobisher C, Winter DL, Kelly J, Lancashire ER, Stiller CA. et al; British childhood cancer survivor study steering group. Long-term risks of subsequent primary neoplasms among survivors of childhood cancer. JAMA. 2011;305(22):2311–9. https://doi.org/10.1001/jama.2011.747.

    Article  CAS  PubMed  Google Scholar 

  15. Jazbec J, Ećimović P, Jereb B. Second neoplasms after treatment of childhood cancer in Slovenia. Pediatr Blood Cancer. 2004;42(7):574–81. https://doi.org/10.1002/pbc.20025.

    Article  PubMed  Google Scholar 

  16. Henderson TO, Oeffinger KC, Whitton J, Leisenring W, Neglia J, Meadows A, et al. Secondary gastrointestinal cancer in childhood cancer survivors: a cohort study. Ann Intern Med. 2012;156(11):757–66. https://doi.org/10.1059/0003-4819-156-11-201206050-00002.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bhatia S, Yasui Y, Robison LL, Birch JM, Bogue MK, Diller L, et al. Late effects study group. High risk of subsequent neoplasms continues with extended follow-up of childhood Hodgkin’s disease: report from the late effects study group. J Clin Oncol. 2003;21(23):4386–94. https://doi.org/10.1200/JCO.2003.11.059.

    Article  PubMed  Google Scholar 

  18. Metayer C, Lynch CF, Clarke EA, Glimelius B, Storm H, Pukkala E, et al. Second cancers among long-term survivors of Hodgkin’s disease diagnosed in childhood and adolescence. J Clin Oncol. 2000;18(12):2435–43. https://doi.org/10.1200/JCO.2000.18.12.2435.

    Article  CAS  PubMed  Google Scholar 

  19. Nottage K, McFarlane J, Krasin MJ, Li C, Srivastava D, Robison LL, et al. Secondary colorectal carcinoma after childhood cancer. J Clin Oncol. 2012;30:2552–8. https://doi.org/10.1200/JCO.2011.37.8760.

    Article  PubMed  Google Scholar 

  20. Tukenova M, Diallo I, Anderson H, Hawkins M, Garwicz S, Sankila R, et al. Second malignant neoplasms in digestive organs after childhood cancer: a cohort-nested case-control study. Int J Radiat Oncol Biol Phys. 2012;82:383–90. https://doi.org/10.1016/j.ijrobp.2011.05.069.

    Article  Google Scholar 

  21. Landier W, Bhatia S, Eshelman DA, Forte KJ, Sweeney T. Hester AL et al. Development of risk-based guidelines for pediatric cancer survivors: the children’s oncology group long-term follow-up guidelines from the children’s oncology group late effects committee and nursing discipline. J Clin Oncol. 2004;22(24):4979–90. https://doi.org/10.1200/JCO.2004.11.032.

    Article  PubMed  Google Scholar 

  22. Children’s Oncology Group. Long-term, follow-up guidelines for survivors of childhood, adolescent, and young adult cancer. 2013 [cited Volume version 4].

  23. Children's Oncology Group. Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers. Version 5.0 Monrovia, CA: Children's Oncology Group; 2018. http://www.survivorshipguidelines.org. Accessed March 20, 2019.

  24. Jereb B. Model for long-term follow-up of survivors of childhood cancer. Med Pediatr Oncol. 2000;34:256–8. https://doi.org/10.1002/(SICI)1096-911X(200004)34:4<256::AID-MPO5>3.0.CO;2-8.

    Article  CAS  PubMed  Google Scholar 

  25. Glockenberg KS, Shah P, Shike M, Oeffinger KC, Tonorezos ES. Colon adenoma and carcinoma among adult survivors of childhood and young adult cancer. J Gastroenterol Hepatol Res. 2017;6(5):2425–529. https://doi.org/10.17554/j.issn.2224-3992.2017.06.729.

    Article  Google Scholar 

  26. Daly PE, Samiee S, Cino M, Gryfe R, Pollett A, Ng A, et al. High prevalence of adenomatous colorectal polyps in young cancer survivors treated with abdominal radiation therapy: results of a prospective trial. Gut. 2017;66(10):1797–801. https://doi.org/10.1136/gutjnl-2016-311501.

    Article  PubMed  Google Scholar 

  27. Chung SJ, Kim YS, Yang SY, Song JH, Park MJ, Kim JS, et al. Prevalence and risk of colorectal adenoma in 75 asymptomatic Koreans aged 40-49 years undergoing screening colonoscopy. J Gastroenterol Hepatol. 2010;25(3):519–25. https://doi.org/10.1111/j.1440-1746.2009.06147.x.

    Article  PubMed  Google Scholar 

  28. Hemmasi G, Sohrabi M, Zamani F, Ajdarkosh H, Rakhshani N, Khoonsari M, et al. Prevalence of colorectal adenoma in an average-risk population aged 40-50 versus 50-60 years. Eur J Cancer Prev. 2015;24(5):386–90. https://doi.org/10.1097/CEJ.0000000000000097.

    Article  PubMed  Google Scholar 

  29. Eide TJ. Risk of colorectal cancer in adenoma-bearing individuals within a defined population. Int J Cancer. 1986;38:173–6. https://doi.org/10.1002/ijc.2910380205.

    Article  CAS  PubMed  Google Scholar 

  30. Stryker SJ, Wolff BG, Culp CE, Libbe SD, Ilstrup DM, MacCarty RL. Natural history of untreated colonic polyps. Gastroenterology. 1987;93(5):1009–13. https://doi.org/10.1016/0016-5085(87)90563-4.

    Article  CAS  PubMed  Google Scholar 

  31. Lin JS, Piper MA, Perdue LA, Rutter CM, Webber EM, O'Connor E, et al. Screening for colorectal cancer: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2016;315(23):2576–94. https://doi.org/10.1001/jama.2016.3332.

    Article  CAS  PubMed  Google Scholar 

  32. Teepen JC, Kok JL, van Leeuwen FE, Tissing WJE, Dolsma WV, van der Pal HJ, et al. Colorectal adenomas and cancers after childhood cancer treatment: A DCOG-LATER Record Linkage Study. JNCI: Journal of the National Cancer Institute. 2018;110(7):758–67. https://doi.org/10.1093/jnci/djx266.

    Article  PubMed  Google Scholar 

  33. Allodji RS, Haddy N, Vu-Bezin G, Dumas A, Fresneau B, Mansouri I, et al. Risk of subsequent colorectal cancers after a solid tumor in childhood: Effects of radiation therapy and chemotherapy. Pediatr Blood Cancer. 2018:e27495. https://doi.org/10.1002/pbc.27495.

  34. The Svit Programme - 10 Years of colorectal cancer screening in Slovenia : compendium on the 10th anniversary of the Svit Programme. [ebook] Ljubljana. 2019. https://www.program-svit.si/wp-content/uploads/2019/10/SVIT-10-LET-ANG - Elektronska.pdf. Accessed 4 January 2021.

  35. Miles A, Atkin W, Kralj-Hans I, Wardle J. The psychological impact of being offered surveillance colonoscopy following attendance at colorectal screening using flexible sigmoidoscopy. J Med Screen. 2009;16(3):124–30. https://doi.org/10.1258/jms.2009.009041.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Radiotherapy Department, Institute of Oncology Ljubljana, Zaloška 2, Ljubljana, Slovenia

    Lorna Zadravec Zaletel & Gregor Kos

  2. Faculty of medicine, University of Ljubljana, Vrazov trg 2, Ljubljana, Slovenia

    Lorna Zadravec Zaletel

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  1. Lorna Zadravec Zaletel
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Correspondence to Lorna Zadravec Zaletel.

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Zadravec Zaletel, L., Kos, G. Screening colonoscopy according to guidelines in long-term survivors of childhood cancer—results of a population-based study. J Cancer Surviv 16, 455–460 (2022). https://doi.org/10.1007/s11764-021-01040-8

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