Although rarely fatal, NMSC is an important late effect of childhood cancer therapy and an important public health issue. In the CCSS, the largest proportion of NMSC occurred in survivors of HL (37.9%), leukemia (32.1%), and CNS tumors (9.3%). The SEER Program does not collect incidence data on NMSC; thus we have a limited ability to track overall NMSC rates and trends in the United States and to compare the results of the CCSS with that of the general population. However, the CCSS rates of NMSC exceed those reported in a population-based study done in New Hampshire.30 The locations of basal cell carcinomas observed in the subjects of the New Hampshire study were also quite different from those in the CCSS group, which reflect the sites of radiotherapy. In the New Hampshire group, basal cell carcinomas were reported as head/neck (68%), back/chest (21%), or extremity (11%), and in the CCSS group, head/neck (43%), back/chest (51%), or extremity (3%). Similarly high rates of NMSC have been identified in survivors of hematopoietic stem-cell transplantation, in whom the risk of basal cell carcinoma is increased by total-body irradiation during childhood, and that of basal cell and squamous cell carcinomas is increased by graft-versus-host disease.
Although rarely fatal, NMSC is an important late effect of childhood cancer therapy and an important public health issue. In the CCSS, the largest proportion of NMSC occurred in survivors of HL (37.9%), leukemia (32.1%), and CNS tumors (9.3%). The SEER Program does not collect incidence data on NMSC; thus we have a limited ability to track overall NMSC rates and trends in the United States and to compare the results of the CCSS with that of the general population. However, the CCSS rates of NMSC exceed those reported in a population-based study done in New Hampshire.30 The locations of basal cell carcinomas observed in the subjects of the New Hampshire study were also quite different from those in the CCSS group, which reflect the sites of radiotherapy. In the New Hampshire group, basal cell carcinomas were reported as head/neck (68%), back/chest (21%), or extremity (11%), and in the CCSS group, head/neck (43%), back/chest (51%), or extremity (3%). Similarly high rates of NMSC have been identified in survivors of hematopoietic stem-cell transplantation, in whom the risk of basal cell carcinoma is increased by total-body irradiation during childhood, and that of basal cell and squamous cell carcinomas is increased by graft-versus-host disease.
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