Long-Term Survival and Risk of Second Malignant Neoplasms Among Childhood Cancer Patients in 16 Provinces of Spain
Jaume Galceran, Alberto Ameijide, Noura Jeghalef, Antonia Sánchez, Marcela Guevara, Jàmnica Bigorra, Pilar Gutiérrez, An L. D. Boone, Montserrat Garrido, Xitama Álvarez, Ana Vizcaíno, Isabel Martín, Amaia Onaindia, Silvia Sanclemente, Jan Trallero, María José Sánchez, María-Isabel Palacios, Ramon Clèries, Marià Carulla,Background: Childhood cancer survivors have a higher risk of developing malignancies later in life compared with individuals of similar age in the general population. In Spain, population-based evidence on second malignant neoplasms (SMNs) is limited. This study aimed to estimate survival following childhood cancer diagnosis and to assess the risk of SMNs in Spain. Methods: This population-based registry study used data from 12 cancer registries within the Spanish Network of Cancer Registries (REDECAN). All malignancies of sites and non-malignant central nervous system (CNS) tumors diagnosed before age 15 were included. Age-standardized incidence rates (ASIRw) for 2015–2019 were calculated. Five- and 10-year age-adjusted observed survival rates for 1990–1999 and 2000–2009 were estimated. SMN risk was assessed using standardized incidence ratios (SIRs) and excess absolute risks (EARs). Results: The ASIRw for 2015–2019 was 181.3 per million child-years. Ten-year survival increased from 71.3% in 1990–1999 to 75.5% in 2000–2009. The overall risk of developing an SMN was significantly elevated (SIR = 5.67) at 20 years. Conclusions: Although survival for childhood cancer in Spain was around 75% in 2000–2009, childhood cancer survivors remain at substantially increased risk of SMNs for at least two decades. Efforts to reduce treatment-related toxicity while maintaining survival gains are essential.