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Risk of Leukemia Among Survivors of Testicular Cancer: A Population-based Study of 42,722 Patients

Lookup NU author(s): Professor James Allan


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Purpose: The aim of this study is to quantify excess absolute risk (EAR) and excess relative risk (ERR) of secondary leukemia among a large population-based group of testicular cancer survivors. Methods: We identified 42,722 1-year survivors of testicular cancer within 14 population-based cancer registries in Europe and North America (1943-2002). Poisson regression analysis was used to model EAR (per 100,000 person-years [PY]) and ERR of secondary leukemia. Cumulative risks were calculated using a competing risk model. Results: Secondary leukemia developed in 89 patients (EAR = 10.8 per 100,000 PY, 95% confidence interval [CI] = 7.6-14.6; ERR = 1.6, 95%CI = 1.0-2.2). Statistically significantly elevated risks were observed for acute myeloid leukemia (AML) (EAR = 7.2, 95%CI = 4.7-10.2) and acute lymphoblastic leukemia (EAR = 1.3, 95%CI = 0.4-2.8). In multivariate analyses, AML risk was higher among patients whose initial management included chemotherapy compared to those receiving radiotherapy alone (p = 0.1). Excess cumulative leukemia risk was approximately 0.23% by 30 years after testicular cancer diagnosis. Conclusions: Although ERR of leukemia following testicular cancer is large, EAR and cumulative risk, which are better gauges of the population burden, are small. © 2008 Elsevier Inc. All rights reserved.

Publication metadata

Author(s): Howard R, Gilbert E, Lynch C, Hall P, Storm H, Holowaty E, Pukkala E, Langmark F, Kaijser M, Andersson M, Joensuu H, Fossa S, Allan JM, Travis L

Publication type: Article

Publication status: Published

Journal: Annals of Epidemiology

Year: 2008

Volume: 18

Issue: 5

Pages: 416-421

ISSN (print): 1047-2797

ISSN (electronic): 1873-2585

Publisher: Elsevier Inc.


DOI: 10.1016/j.annepidem.2008.01.003

PubMed id: 18433667


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Funder referenceFunder name
ZIA CP010131-18Intramural NIH HHS