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 a...
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| Veröffentlicht in: | International journal of cancer 2015-08, Vol.137 (3), p.658-665 |
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| container_title | International journal of cancer |
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| creator | Chien, Sheng‐Hsuan Liu, Chia‐Jen Hu, Yu‐Wen Hong, Ying‐Chung Teng, Chung‐Jen Yeh, Chiu‐Mei Chiou, Tzeon‐Jye Gau, Jyh‐Pyng Tzeng, Cheng‐Hwai |
| description | 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 |
| doi_str_mv | 10.1002/ijc.29433 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1773836649</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3687112971</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4573-2ac1a6d267012a46b7528b4f237a5c0cc5057a80568b534a73424203935a71793</originalsourceid><addsrcrecordid>eNqNkc9O4zAQxq3Vom1h98ALIEt74RLwfyd7qypKQUhc4Bw5jtu6JHY2TkC58Qi8AC_Hk-CGwmFPe5oZzU_faL4PgGOMzjBC5Nxu9RnJGKXfwBSjTCaIYP4dTOMOJRJTMQGHIWwRwpgj9gNMCBcUSSGm4HXRmr-9cXqAfgVD3z4aW1XKaQO1r5u-MyXsfO3XrWo2A7QOOu_enl-Wvlw_xKka6mbjawWVi-DGwNaGh1HKaO9K1Q6waW29q7Wq7NpFaWvCHziDTnXWuydbGtj4pq_GMUoXKsSjoevL4Sc4WKkqmF_7egTuFxd382Vyc3t5NZ_dJJpxSROiNFaiJEIiTBQTheQkLdiKUKm4RlpzxKVKERdpwSlTkjLCCKIZ5UpimdEjcPqh27Q-uhG6vLZBm50Rxvchx1LSlArB_gMVKc4wo5JH9Pc_6Nb3rYuPjBShgoud4Mme6ovalPnervwzowicfwBPtjLD1x6jfBd-HsPPx_Dzq-v52NB3cMqj2w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1681236569</pqid></control><display><type>article</type><title>Frequency of surveillance computed tomography in non‐Hodgkin lymphoma and the risk of secondary primary malignancies: A nationwide population‐based study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Chien, Sheng‐Hsuan ; Liu, Chia‐Jen ; Hu, Yu‐Wen ; Hong, Ying‐Chung ; Teng, Chung‐Jen ; Yeh, Chiu‐Mei ; Chiou, Tzeon‐Jye ; Gau, Jyh‐Pyng ; Tzeng, Cheng‐Hwai</creator><creatorcontrib>Chien, Sheng‐Hsuan ; Liu, Chia‐Jen ; Hu, Yu‐Wen ; Hong, Ying‐Chung ; Teng, Chung‐Jen ; Yeh, Chiu‐Mei ; Chiou, Tzeon‐Jye ; Gau, Jyh‐Pyng ; Tzeng, Cheng‐Hwai</creatorcontrib><description>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 < 0.001) than those with ≤8 scans and this difference remained significant even after correction with propensity score matching. Among the 180 SPM identified, those receiving more CT scans had significantly higher SPM incidence in cancers of the breast (HR 11.22), stomach (HR 5.22) and liver and biliary tract (HR 2.18) in comparison to those with less exposure. The risk of SPM was estimated to increase 3% per one more CT scan performed. Our study demonstrated that after curative‐intent treatment, patients with NHL receiving more frequent surveillance CT scans would have an increased risk of SPM.
What's new?
Frequent surveillance with CT scans is routine practice to monitor patients with Non‐Hodgkin lymphomas (NHLs), during treatment and when primary tumors are in remission. Here the authors demonstrate that this practice increases the risk for secondary malignancies. In their study, patients receiving more than 8 CT scans had a significantly higher risk than patients exposed to fewer scans, with secondary cancers most frequently arising in breast, stomach and liver. These results are striking and could lead to a more restricted use of surveillance scans in the future.</description><identifier>ISSN: 0020-7136</identifier><identifier>EISSN: 1097-0215</identifier><identifier>DOI: 10.1002/ijc.29433</identifier><identifier>PMID: 25630766</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Cancer ; cancer risk ; Comorbidity ; computed tomography ; epidemiology ; Female ; Humans ; Incidence ; Lymphoma ; Lymphoma, Non-Hodgkin - diagnosis ; Male ; Medical imaging ; Medical research ; Middle Aged ; Neoplasms, Second Primary - diagnosis ; Neoplasms, Second Primary - epidemiology ; Neoplasms, Second Primary - etiology ; Odds Ratio ; Population Surveillance ; radiation exposure ; Risk ; secondary malignancy ; Surveillance ; Taiwan - epidemiology ; Time Factors ; Tomography ; Tomography, X-Ray Computed - adverse effects</subject><ispartof>International journal of cancer, 2015-08, Vol.137 (3), p.658-665</ispartof><rights>2015 UICC</rights><rights>2015 UICC.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4573-2ac1a6d267012a46b7528b4f237a5c0cc5057a80568b534a73424203935a71793</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fijc.29433$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fijc.29433$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27911,27912,45561,45562</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25630766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chien, Sheng‐Hsuan</creatorcontrib><creatorcontrib>Liu, Chia‐Jen</creatorcontrib><creatorcontrib>Hu, Yu‐Wen</creatorcontrib><creatorcontrib>Hong, Ying‐Chung</creatorcontrib><creatorcontrib>Teng, Chung‐Jen</creatorcontrib><creatorcontrib>Yeh, Chiu‐Mei</creatorcontrib><creatorcontrib>Chiou, Tzeon‐Jye</creatorcontrib><creatorcontrib>Gau, Jyh‐Pyng</creatorcontrib><creatorcontrib>Tzeng, Cheng‐Hwai</creatorcontrib><title>Frequency of surveillance computed tomography in non‐Hodgkin lymphoma and the risk of secondary primary malignancies: A nationwide population‐based study</title><title>International journal of cancer</title><addtitle>Int J Cancer</addtitle><description>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 < 0.001) than those with ≤8 scans and this difference remained significant even after correction with propensity score matching. Among the 180 SPM identified, those receiving more CT scans had significantly higher SPM incidence in cancers of the breast (HR 11.22), stomach (HR 5.22) and liver and biliary tract (HR 2.18) in comparison to those with less exposure. The risk of SPM was estimated to increase 3% per one more CT scan performed. Our study demonstrated that after curative‐intent treatment, patients with NHL receiving more frequent surveillance CT scans would have an increased risk of SPM.
What's new?
Frequent surveillance with CT scans is routine practice to monitor patients with Non‐Hodgkin lymphomas (NHLs), during treatment and when primary tumors are in remission. Here the authors demonstrate that this practice increases the risk for secondary malignancies. In their study, patients receiving more than 8 CT scans had a significantly higher risk than patients exposed to fewer scans, with secondary cancers most frequently arising in breast, stomach and liver. These results are striking and could lead to a more restricted use of surveillance scans in the future.</description><subject>Adult</subject><subject>Cancer</subject><subject>cancer risk</subject><subject>Comorbidity</subject><subject>computed tomography</subject><subject>epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Lymphoma</subject><subject>Lymphoma, Non-Hodgkin - diagnosis</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Neoplasms, Second Primary - diagnosis</subject><subject>Neoplasms, Second Primary - epidemiology</subject><subject>Neoplasms, Second Primary - etiology</subject><subject>Odds Ratio</subject><subject>Population Surveillance</subject><subject>radiation exposure</subject><subject>Risk</subject><subject>secondary malignancy</subject><subject>Surveillance</subject><subject>Taiwan - epidemiology</subject><subject>Time Factors</subject><subject>Tomography</subject><subject>Tomography, X-Ray Computed - adverse effects</subject><issn>0020-7136</issn><issn>1097-0215</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc9O4zAQxq3Vom1h98ALIEt74RLwfyd7qypKQUhc4Bw5jtu6JHY2TkC58Qi8AC_Hk-CGwmFPe5oZzU_faL4PgGOMzjBC5Nxu9RnJGKXfwBSjTCaIYP4dTOMOJRJTMQGHIWwRwpgj9gNMCBcUSSGm4HXRmr-9cXqAfgVD3z4aW1XKaQO1r5u-MyXsfO3XrWo2A7QOOu_enl-Wvlw_xKka6mbjawWVi-DGwNaGh1HKaO9K1Q6waW29q7Wq7NpFaWvCHziDTnXWuydbGtj4pq_GMUoXKsSjoevL4Sc4WKkqmF_7egTuFxd382Vyc3t5NZ_dJJpxSROiNFaiJEIiTBQTheQkLdiKUKm4RlpzxKVKERdpwSlTkjLCCKIZ5UpimdEjcPqh27Q-uhG6vLZBm50Rxvchx1LSlArB_gMVKc4wo5JH9Pc_6Nb3rYuPjBShgoud4Mme6ovalPnervwzowicfwBPtjLD1x6jfBd-HsPPx_Dzq-v52NB3cMqj2w</recordid><startdate>20150801</startdate><enddate>20150801</enddate><creator>Chien, Sheng‐Hsuan</creator><creator>Liu, Chia‐Jen</creator><creator>Hu, Yu‐Wen</creator><creator>Hong, Ying‐Chung</creator><creator>Teng, Chung‐Jen</creator><creator>Yeh, Chiu‐Mei</creator><creator>Chiou, Tzeon‐Jye</creator><creator>Gau, Jyh‐Pyng</creator><creator>Tzeng, Cheng‐Hwai</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7T5</scope><scope>7TO</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope></search><sort><creationdate>20150801</creationdate><title>Frequency of surveillance computed tomography in non‐Hodgkin lymphoma and the risk of secondary primary malignancies: A nationwide population‐based study</title><author>Chien, Sheng‐Hsuan ; Liu, Chia‐Jen ; Hu, Yu‐Wen ; Hong, Ying‐Chung ; Teng, Chung‐Jen ; Yeh, Chiu‐Mei ; Chiou, Tzeon‐Jye ; Gau, Jyh‐Pyng ; Tzeng, Cheng‐Hwai</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4573-2ac1a6d267012a46b7528b4f237a5c0cc5057a80568b534a73424203935a71793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Cancer</topic><topic>cancer risk</topic><topic>Comorbidity</topic><topic>computed tomography</topic><topic>epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Lymphoma</topic><topic>Lymphoma, Non-Hodgkin - diagnosis</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Neoplasms, Second Primary - diagnosis</topic><topic>Neoplasms, Second Primary - epidemiology</topic><topic>Neoplasms, Second Primary - etiology</topic><topic>Odds Ratio</topic><topic>Population Surveillance</topic><topic>radiation exposure</topic><topic>Risk</topic><topic>secondary malignancy</topic><topic>Surveillance</topic><topic>Taiwan - epidemiology</topic><topic>Time Factors</topic><topic>Tomography</topic><topic>Tomography, X-Ray Computed - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chien, Sheng‐Hsuan</creatorcontrib><creatorcontrib>Liu, Chia‐Jen</creatorcontrib><creatorcontrib>Hu, Yu‐Wen</creatorcontrib><creatorcontrib>Hong, Ying‐Chung</creatorcontrib><creatorcontrib>Teng, Chung‐Jen</creatorcontrib><creatorcontrib>Yeh, Chiu‐Mei</creatorcontrib><creatorcontrib>Chiou, Tzeon‐Jye</creatorcontrib><creatorcontrib>Gau, Jyh‐Pyng</creatorcontrib><creatorcontrib>Tzeng, Cheng‐Hwai</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>International journal of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chien, Sheng‐Hsuan</au><au>Liu, Chia‐Jen</au><au>Hu, Yu‐Wen</au><au>Hong, Ying‐Chung</au><au>Teng, Chung‐Jen</au><au>Yeh, Chiu‐Mei</au><au>Chiou, Tzeon‐Jye</au><au>Gau, Jyh‐Pyng</au><au>Tzeng, Cheng‐Hwai</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Frequency of surveillance computed tomography in non‐Hodgkin lymphoma and the risk of secondary primary malignancies: A nationwide population‐based study</atitle><jtitle>International journal of cancer</jtitle><addtitle>Int J Cancer</addtitle><date>2015-08-01</date><risdate>2015</risdate><volume>137</volume><issue>3</issue><spage>658</spage><epage>665</epage><pages>658-665</pages><issn>0020-7136</issn><eissn>1097-0215</eissn><abstract>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 < 0.001) than those with ≤8 scans and this difference remained significant even after correction with propensity score matching. Among the 180 SPM identified, those receiving more CT scans had significantly higher SPM incidence in cancers of the breast (HR 11.22), stomach (HR 5.22) and liver and biliary tract (HR 2.18) in comparison to those with less exposure. The risk of SPM was estimated to increase 3% per one more CT scan performed. Our study demonstrated that after curative‐intent treatment, patients with NHL receiving more frequent surveillance CT scans would have an increased risk of SPM.
What's new?
Frequent surveillance with CT scans is routine practice to monitor patients with Non‐Hodgkin lymphomas (NHLs), during treatment and when primary tumors are in remission. Here the authors demonstrate that this practice increases the risk for secondary malignancies. In their study, patients receiving more than 8 CT scans had a significantly higher risk than patients exposed to fewer scans, with secondary cancers most frequently arising in breast, stomach and liver. These results are striking and could lead to a more restricted use of surveillance scans in the future.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>25630766</pmid><doi>10.1002/ijc.29433</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Cancer cancer risk Comorbidity computed tomography epidemiology Female Humans Incidence Lymphoma Lymphoma, Non-Hodgkin - diagnosis Male Medical imaging Medical research Middle Aged Neoplasms, Second Primary - diagnosis Neoplasms, Second Primary - epidemiology Neoplasms, Second Primary - etiology Odds Ratio Population Surveillance radiation exposure Risk secondary malignancy Surveillance Taiwan - epidemiology Time Factors Tomography Tomography, X-Ray Computed - adverse effects |
| title | Frequency of surveillance computed tomography in non‐Hodgkin lymphoma and the risk of secondary primary malignancies: A nationwide population‐based study |
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