Cohort Profile: The Socioeconomic Consequences in Adult Life After Childhood Cancer in Scandinavia (SALiCCS) Research Programme

IntroductionThe growing number of survivors of childhood cancer, with many years of life ahead, demonstrates the increasing clinical and public health relevance of investigating the risks of social and socioeconomic impairment after a childhood cancer diagnosis and the life-saving treatment. To enrich understanding of the mental, social and socioeconomic difficulties that childhood cancer survivors may face during their life-course, identify particularly vulnerable survivors and overcome the limitations of previous research, we initiated the Socioeconomic Consequences in Adult Life after Childhood Cancer in Scandinavia (SALiCCS) research programme.MethodsThis Nordic cross-border research programme is a collaboration between the Danish Cancer Society, the Finnish Cancer Registry and Karolinska Institutet to investigate a broad range of mental, social and socioeconomic conditions in long-term childhood cancer survivors in Denmark, Finland and Sweden. SALiCCS is based on a registry-based matched cohort design, comprising five-year survivors of cancer diagnosed at ages 0–19 years (1971–2008 in Denmark, 1971–2009 in Finland, 1971–2011 in Sweden), age-, sex- and country-matched population comparisons and sibling comparisons who were followed over time. Outcomes of interest included mental disorders, educational achievements, employment and profession, family life and the need of social security benefits. Individual-level data linkage among various national registries provided the data for the research programme.ResultsThe SALiCCS core population comprises 21,292 five-year survivors, 103,303 population comparisons and 29,644 siblings as a second comparison group. The most common diagnoses in survivors were central nervous system tumours, leukaemias and lymphomas.DiscussionSALiCCS is the largest, most comprehensive population-based research initiative in this field, based on high-quality registry data with minimal risk of bias. The findings will be informative for evidence-based survivorship care targeting not only somatic late effects but also psychosocial impairments.

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Psychiatric disorders in childhood cancer survivors in Denmark, Finland, and Sweden: a register-based cohort study from the SALiCCS research programme

The Lancet Psychiatry ◽

10.1016/s2215-0366(21)00387-4 ◽

2021 ◽

Author(s):

Line Elmerdahl Frederiksen ◽

Friederike Erdmann ◽

Luzius Mader ◽

Hanna Mogensen ◽

Camilla Pedersen ◽

...

Keyword(s):

Cohort Study ◽

Cancer Survivors ◽

Childhood Cancer ◽

Psychiatric Disorders ◽

Research Programme ◽

Childhood Cancer Survivors

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Genetic and treatment risks for diabetes mellitus (DM) in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study (CCSS) and St. Jude Lifetime (SJLIFE) cohorts.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.10014 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 10014-10014

Author(s):

Melissa A. Richard ◽

Sogol Mostoufi-Moab ◽

Nisha Rathore ◽

Austin L. Brown ◽

Stephen J. Chanock ◽

...

Keyword(s):

Risk Factors ◽

Cancer Survivors ◽

Cancer Treatment ◽

Childhood Cancer ◽

Regulatory Region ◽

Childhood Cancer Survivors ◽

Population Based ◽

European Ancestry ◽

Radiation Group ◽

Increased Risk

10014 Background: Childhood cancer survivors face increased risk for DM, a polygenic trait also attributable to cancer treatment exposures, particularly abdominal radiation. We aimed to characterize the role of genetic and treatment risk factors for DM among two large cohorts of childhood cancer survivors. Methods: We performed a nested case-control genome-wide association study for DM managed with oral medications in the original CCSS cohort (diagnosed 1970-1986). Logistic regression was conducted in the total sample (N = 5083) and stratified by 1) European ancestry (EA) and 2) abdominal radiation. Replication of suggestive variants (P < 1×10-7) using Fisher’s exact test was performed in independent cohorts: i) CCSS expansion diagnosed 1987-1999 (N = 2588) and ii) SJLIFE diagnosed 1962-2012 (N = 2182). To evaluate the effect of cancer treatment on the background genetic predisposition to DM, we estimated standardized effect sizes (Z’) among EA survivors in each abdominal radiation group for 398 index variants from the largest population-based EA DM study. Radiation group Z’ estimates were compared using linear regression. Results: In the original CCSS cohort we identified nine variants associated with DM and provide further support for four linked variants in the ERCC6L2 locus. Among all survivors, the rs55849673-A allele was associated with increased odds for DM among survivors in the original CCSS cohort (minor allele frequency [MAF]-cases = 0.055; MAF-controls = 0.024; adjusted odds ratio [aOR] = 2.9, 95% CI: 2.0-4.2, P = 3.7×10-8). Allele frequencies were consistent in the CCSS expansion (MAF-cases = 0.075; MAF-controls = 0.028; P = 0.07) and SJLIFE (MAF-cases = 0.036; MAF-controls = 0.027; P = 0.5). Additionally, rs55849673-A estimates were consistent among EA survivors and stronger among survivors not treated with abdominal radiation (MAF-cases = 0.052; MAF-controls = 0.021; aOR = 3.6, P = 1.6×10-6). Notably, in the CCSS expansion all rs55849673-A EA carriers who developed DM did not receive abdominal radiation (MAF-cases = 0.1; MAF-controls = 0.026; P = 0.04). More broadly, the Z’ of population-based DM index variants were 78% lower in survivors treated with abdominal radiation than survivors not treated with abdominal radiation (beta = 0.22; P = 0.01), indicating the background genetic risk for DM may be altered by treatment. Conclusions: We provide evidence for a novel locus of DM in childhood cancer survivors. This locus is a regulatory region associated with expression of ERCC6L2, a gene implicated in an East Asian population-based DM study. Taken together, our findings support the overwhelming effect of abdominal radiation on DM risk in childhood cancer survivors, relative to other risk factors, and provide insight on a genetic locus that may be useful for DM risk prediction in the context of cancer treatment.

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Incidence of Influenza Among Childhood Cancer Survivors in South Korea: A Population-based Retrospective Analysis

In Vivo ◽

10.21873/invivo.11860 ◽

2020 ◽

Vol 34 (2) ◽

pp. 929-933 ◽

Cited By ~ 1

Author(s):

JAESUNG HEO ◽

HYUN JOO JUNG ◽

O KYU NOH ◽

LOGYOUNG KIM ◽

JUN EUN PARK

Keyword(s):

South Korea ◽

Cancer Survivors ◽

Childhood Cancer ◽

Retrospective Analysis ◽

Childhood Cancer Survivors ◽

Population Based

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Incidence of Suicide Mortality Among Childhood Cancer Survivors: A Population-based Retrospective Study

Psychiatry Research ◽

10.1016/j.psychres.2021.114119 ◽

2021 ◽

pp. 114119

Author(s):

Xue-Lei Fu ◽

Yan Qian ◽

Xiao-Hong Jin ◽

Hai-Rong Yu ◽

Hua Wu ◽

...

Keyword(s):

Retrospective Study ◽

Cancer Survivors ◽

Childhood Cancer ◽

Childhood Cancer Survivors ◽

Population Based ◽

Suicide Mortality

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Diabetes Risk in Childhood Cancer Survivors: A Population-Based Study

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2018.01.004 ◽

2018 ◽

Vol 42 (5) ◽

pp. 533-539 ◽

Cited By ~ 4

Author(s):

Iliana C. Lega ◽

Jason D. Pole ◽

Peter C. Austin ◽

Cindy Lau ◽

Paul C. Nathan ◽

...

Keyword(s):

Cancer Survivors ◽

Childhood Cancer ◽

Childhood Cancer Survivors ◽

Population Based ◽

Diabetes Risk ◽

Population Based Study

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New insights into the risk of breast cancer in childhood cancer survivors treated with chest radiation: A report from the Childhood Cancer Survivor Study (CCSS) and the Women's Environmental Cancer and Radiation Epidemiology(WECARE) Study.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.18_suppl.cra9513 ◽

2012 ◽

Vol 30 (18_suppl) ◽

pp. CRA9513-CRA9513 ◽

Cited By ~ 5

Author(s):

Chaya S. Moskowitz ◽

Joanne F. Chou ◽

Suzanne L. Wolden ◽

Jonine L. Bernstein ◽

Jyoti Malhotra ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Childhood Cancer ◽

Cumulative Incidence ◽

Childhood Cancer Survivors ◽

Population Based ◽

Cancer Surveillance ◽

Brca1 And Brca2 ◽

First Degree Relatives ◽

Mutation Carriers

CRA9513 Background: The risk of breast cancer (BC) by age 50 among women treated for childhood cancer with chest radiation therapy (RT) and how this risk compares with that of BRCA1 and BRCA2 (BRCA1/2) mutation carriers is unknown. Methods: We evaluated the risk of BC in a cohort of 1268 female 5-yr childhood cancer survivors treated with chest RT and estimated the cumulative incidence of BC non-parametrically treating death as a competing risk. The cumulative incidence of BC in BRCA1/2 mutation carriers was estimated with the kin-cohort method using data from 4570 female first-degree relatives of women diagnosed with unilateral BC (probands) participating in the WECARE Study. Absolute Excess Risks (AERs) were estimated using population-based data from the SEER program. Results: With a median follow-up of 26 yrs (range 5-39) for the CCSS cohort, 175 women were diagnosed with BC at a median age of 38 yrs (range 24-53) and a median latency of 23 yrs (range 7-38); the overall cumulative incidence of BC by age 50 was 24% (95% confidence interval [CI] 20-28%) and among Hodgkin lymphoma survivors was 30% (95% CI 25-35%). In comparison, among first-degree relatives of WECARE Study probands 324 were diagnosed with BC (median age at diagnosis, 55 yrs (range 26-90)). The estimated cumulative incidence by age 50 was 31% (95% CI 16-47%) and 10% (95% CI 2-23%) in carriers of BRCA1 and BRCA2 mutations, respectively. The population cumulative incidence of BC is 4% by age 50. Among the childhood cancer survivors, AERs for BCs diagnosed per 10,000 person-years of observation were respectively 34 (95% CI 18-52), 27 (95% CI 11-45), and 95 (95% CI 78-112) among women treated with 10-19 Gy (23%), 20-29 Gy (17%), and 30+ Gy (56%) of chest RT. Conclusions: Women treated for childhood cancer with chest RT have a substantial risk of BC comparable to BRCA1/2 mutation carriers and considerably greater than that of the general population. Women treated with 10-19 Gy RT had an increased excess risk warranting consideration of breast cancer surveillance strategies similar to the current recommendations for women treated with > 20 Gy.

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A Population-Based Study of Childhood Cancer Survivors’ Body Mass Index

Journal of Cancer Epidemiology ◽

10.1155/2014/531958 ◽

2014 ◽

Vol 2014 ◽

pp. 1-10 ◽

Cited By ~ 10

Author(s):

Echo L. Warner ◽

Mark Fluchel ◽

Jennifer Wright ◽

Carol Sweeney ◽

Kenneth M. Boucher ◽

...

Keyword(s):

Cancer Survivors ◽

Childhood Cancer ◽

Adult Survivors ◽

Childhood Cancer Survivors ◽

Population Based ◽

Central Nervous System Tumor ◽

Linear Regression Models ◽

Population Database ◽

Relative Risks ◽

Comparison Cohort

Background.Population-based studies are needed to estimate the prevalence of underweight or overweight/obese childhood cancer survivors.Procedure.Adult survivors (diagnosed ≤20 years) were identified from the linked Utah Cancer Registry and Utah Population Database. We included survivors currently aged ≥20 years and ≥5 years from diagnosis(N=1060), and a comparison cohort selected on birth year and sex(N=5410). BMI was calculated from driver license data available from 2000 to 2010. Multivariable generalized linear regression models were used to calculate prevalence relative risks (RR) and 95% confidence intervals (95% CI) of BMI outcomes for survivors and the comparison cohort.Results.Average time since diagnosis was 18.5 years(SD=7.8), and mean age at BMI for both groups was 30.5 (survivorsSD=7.7, comparisonSD=8.0). Considering all diagnoses, survivors were not at higher risk for being underweight or overweight/obese than the comparison. Male central nervous system tumor survivors were overweight (RR=1.12, 95% CI 1.01–1.23) more often than the comparison. Female survivors, who were diagnosed at age 10 and under, had a 10% higher risk of being obese than survivors diagnosed at ages 16–20(P<0.05).Conclusion.While certain groups of childhood cancer survivors are at risk for being overweight/obese, in general they do not differ from population estimates.

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