Frequency of surveillance computed tomography in non‐Hodgkin lymphoma and the risk of secondary primary malignancies: A nationwide population‐based study

With increasing usage of computed tomography (CT) for lymphoma patients receiving curative‐intent treatment, development of secondary primary malignancy (SPM) related to radiation from CT scans becomes an emerging issue in these long‐term survivors. We conducted a nationwide population‐based study analyzing non‐Hodgkin lymphoma (NHL) patients receiving curative‐intent treatment between January 1997 and December 2010. Patients were divided into two populations by the medium number of CT performed. The cumulative incidence of SPM in these two groups was compared using the Kaplan–Meier method. Propensity score matching was applied to eliminate potential confounders. Group stratification and multivariate analyses calculated by Cox proportional hazard models using competing risk analyses adjusted for mortality were performed to identify independent predictors for SPM. Patients receiving >8 CT scans had a significantly greater risk for developing SPM (hazard ratio [HR] 2.25, 95% confidence interval [CI] 1.61–3.13; p