Childhood cancer treatments increase keratinocyte carcinoma risk among survivors
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Key takeaways:
- For all survivors, the cumulative incidence of keratinocyte carcinoma 20 years after patients’ cancer diagnosis was 1.5%.
- Incidence rate for radiotherapy-exposed survivors was 2.6%.
Radiotherapy and hematopoietic cell transplant increased the risk for keratinocyte carcinoma development in childhood cancer survivors, according to a study.
“Childhood cancer survivors remain at high risk for keratinocyte carcinomas (KC), and are at increased risk of developing multiple KCs,” Christina Boull, MD, associate professor of dermatology at the University of Minnesota, told Healio.
To better understand the risk factors and 20-year cumulative incidence of KC in this population, the authors assessed 25,658 childhood cancer survivors.
Results showed that 1,446 of the survivors developed a total of 5,363 KCs, 93.5% of which were basal cell carcinomas and 6.7% were squamous cell carcinomas. The mean lesion count per childhood cancer survivor was 3.7, and 26.1% experienced four or more lesions.
A majority of these patients had received radiotherapy (88.4%), which imparted a 4.5-fold increase in the rate of any KC and a 9.4-fold increase in the rate of four or more KCs, according to the authors.
The authors also found that allogeneic hematopoietic cell transplant was associated with a 3.2-fold increased rate of KC, whereas autologous hematopoietic cell transplant was associated with a 2.3-fold increase.
For all survivors, the cumulative incidence of KC 20 years after patients’ cancer diagnosis was 1.5% (95% CI, 1.3%-1.6%), whereas the incidence rate for radiotherapy-exposed survivors was 2.6% (95% CI, 2.3%-2.9%).
“Childhood cancer survivors are at high risk of KC, especially if they are white, have had radiotherapy or hematopoietic cell transplant and need skin cancer screening starting in the early adult years,” Boull said. “Based on these data we recommend KC screening begin by age 30 or by 20 years post-cancer diagnosis, whichever occurs sooner, in all white CCS and in all CCS with exposure to radiotherapy or hematopoietic cell transplant.”