Risk of subsequent primary melanoma in 68 002 five-year survivors of childhood and adolescent cancer in Europe: the PanCareSurFup cohort study
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Survivors of childhood cancer are at risk of subsequent primary melanoma, but the magnitude of the risk after different childhood cancer types and beyond age 50 years remains inadequately characterized. We quantified risks in the largest cohort of childhood cancer survivors worldwide. METHODS: The PanCare Childhood and Adolescent Cancer Survivor Care and Follow-Up Studies cohort includes 68 002 five-year childhood cancer survivors across Europe (diagnosed 1940-2008). Subsequent primary melanoma risks were quantified using standardized incidence ratios (SIRs), absolute excess risks (AERs), cumulative incidence, and relative risks (RRs). RESULTS: Over 1 239 675 person-years, 197 subsequent primary melanoma were ascertained, whereas 84.9 were expected (SIR = 2.3, 95% confidence interval [CI] = 2.0 to 2.7). Although the standardized incidence ratio decreased with attained age (P for trend < .001), it remained increased at 2.1-fold (95% CI = 1.5 to 3.1) at age 50 years and older. By age 65 years, cumulative incidence was 1.2% (0.8% expected). Of all cancer types, heritable retinoblastoma survivors had the greatest risk (SIR = 16.5, 95% CI = 10.8 to 25.3; AER = 94.4, 95% CI = 59.9 to 148.9), with cumulative incidence of 3.3% at age 50 years and 5.5% at age 60 years. Survivors treated with radiotherapy had a 70% greater risk than those treated without (RR = 1.7, 95% CI = 1.1 to 2.7), increasing to 4.0-fold by age 50 years and older (RR = 3.9, 95% CI = 1.1 to 13.9). For chemotherapy, no statistically significant association was found (RR = 0.9, 95% CI = 0.5 to 1.6). CONCLUSIONS: Childhood cancer survivors, particularly those with heritable retinoblastoma and those treated with radiotherapy, remain at increased risk of melanoma beyond age 50 years. Current survivorship guidelines focus principally on treatment history; however, our findings suggest that long-term follow-up guidelines should additionally include childhood cancer type and attained age as risk-stratifying factors, particularly where individual treatment records are unavailable.
DOI: 10.1093/jnci/djag094
Authors: Behnoush Shojaie, Jop C Teepen, David L Winter, Mike P Gardner, Melanie Kaiser, Desiree Grabow, Cécile M Ronckers, Julianne Byrne, Roderick Skinner, Daniela Alessi, Hama Baqaeen, Rodrigue S Allodji, Helena J H Van Der Pal, Momcilo Jankovic, Francesca Bagnasco, Eva Steliarova-Foucher, Ben D Spycher, Grit Sommer, Edit Bárdi, Thorgerdur Gudmundsdottir, Milena M Maule, Gisela Michel, Monica Muraca, Maria W Gunnes, Line Kenborg, Henrik Hjalgrim, Carlotta Sacerdote, Zsuzsanna Jakab, Riccardo Haupt, Thomas Wiebe, Monica Terenziani, Lorna Zadravec Zaletel, Leontien C M Kremer, Claudia E Kuehni, Päivi M Lähteenmäki, Florent de Vathaire, Lars Hjorth, Michael M Hawkins, Raoul C Reulen
Institutions: University of Birmingham, Princess Máxima Center, Johannes Gutenberg University Mainz, German Cancer Research Center, Boyne Research Institute, Newcastle upon Tyne Hospitals NHS Foundation Trust, Great North Children's Hospital, Newcastle University, Piedmont Reference Center for Epidemiology and Cancer Prevention, University of Turin, Inserm, Université Paris-Saclay, Institut Gustave Roussy, Centre de recherche en Epidémiologie et Santé des Populations, Fondation Gustave Roussy, Azienda Ospedaliera San Gerardo, Istituto Giannina Gaslini, Centre international de recherche sur le cancer, University of Bern, Johannes Kepler University of Linz, Kepler Universitätsklinikum, St Anna Children's Hospital, National University Hospital of Iceland, University of Lucerne, Oslo University Hospital, Cancer Registry of Norway, Semmelweis University, Lund University, Skåne University Hospital, Fondazione IRCCS Istituto Nazionale dei Tumori, University of Ljubljana, Institute of Oncology Ljubljana, Emma Kinderziekenhuis, Amsterdam University Medical Centers, University Children’s Hospital Bern, University of Turku, Turku University Hospital
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,436
Funders: National Science Foundation, Pfizer, Compagnia di San Paolo, European Commission, Agence Nationale de la Recherche, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, Javna Agencija za Raziskovalno Dejavnost RS, Institut National Du Cancer, Swiss Cancer Research Foundation, Pfizer Foundation, National Cancer Institute, CHIST-ERA
Awards: G1023793846, Etude de l'adoucissement de l'acier inoxydable fé- ritique à haute température au cours d'une défor- mation cyclique sous air., G160141216, G181558503, G3419613624, PanCare Childhood and Adolescent Cancer Survivor Care and Follow-up Studies, G4075971419, Mortality and second primary cancers after cancer in childhood and adolescence, G7091189513
OpenAlex ID: W7146977831