Long-Term Survival and Risk of Second Malignant Neoplasms Among Childhood Cancer Patients in 16 provinces of Spain
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 2025–2019 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.
Authors
- Alberto Ameijide (ORCID: https://orcid.org/0000-0002-9285-2627)
- Pilar Gutiérrez (ORCID: https://orcid.org/0000-0002-6997-8846)
- Marià Carulla (ORCID: https://orcid.org/0000-0001-8562-117X)
- Jaume Galcerán (ORCID: https://orcid.org/0000-0002-1584-7293)
- Ramón Clèries (ORCID: https://orcid.org/0000-0002-3637-4747)
- An Lieve Dirk Boone (ORCID: https://orcid.org/0000-0001-5198-8889)
- Marcela Guevara (ORCID: https://orcid.org/0000-0001-9242-6364)
- Jan Trallero (ORCID: https://orcid.org/0009-0000-8283-9966)
- A. Vizcaino-Batllés (ORCID: https://orcid.org/0000-0002-2228-0272)
- María‐José Sánchez (ORCID: https://orcid.org/0000-0003-4817-0757)
- Noura Jeghalef El Karoui (ORCID: https://orcid.org/0000-0002-6153-8918)
- Jàmnica Bigorra
- Amaia Onaindia (ORCID: https://orcid.org/0009-0000-6609-9080)
- Silvia Sanclemente
- Xitama Álvarez
- Isabel Martín (ORCID: https://orcid.org/0009-0001-6314-9107)
- Antonia Sánchez
- María-Isabel Palacios (ORCID: https://orcid.org/0009-0003-8786-197X)
- Montserrat Garrido (ORCID: https://orcid.org/0009-0003-3600-2040)
- on behalf of the Spanish Network of Cancer Registries (REDECAN)
Institutions
- Universitat de Girona (ES)
- Catalan Institute for Water Research (ES)
- Gobierno del Principado de Asturias (ES)
- Basque Government (ES)
- Bellvitge University Hospital (ES)
- Generalitat Valenciana (ES)
- Instituto de Salud Pública de Navarra (ES)
- Institut d'Investigació Biomédica de Bellvitge (ES)
- Clínica Girona (ES)
- Canary Institute of Cancer Research (ES)
- Regional Health (US)
- Institut Català d'Oncologia (ES)
- Navarre Institute of Health Research (ES)
- Technological Institute of Castilla y León (ES)
- Institut d'Investigació Biomèdica de Girona (ES)
- Instituto de Investigación Biosanitaria de Granada (ES)
- Junta de Castilla y León (ES)
- Hospital General Universitari de Castelló (ES)
- Institut de Recerca en Energia de Catalunya (ES)
- Instituto Murciano de Investigación Biosanitaria (ES)
- Hospital Universitari Sant Joan de Reus (ES)
- Hospital Universitari Joan XXIII de Tarragona (ES)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (ES)
- Gobierno de La Rioja (ES)
- Andalusian School of Public Health (ES)
- Universitat de Barcelona (ES)
- Universidad de Murcia (ES)
Publication Details
- Journal
- Cancers
- Published
- 2026-06-18
- DOI
- https://doi.org/10.3390/cancers18121991
- Primary Topic
- Childhood Cancer Survivors' Quality of Life
- Type
- article
- Field-Weighted Citation Impact
- 0.00