Therapy-Associated Polyposis in Younger Patients with Cancer

In recent years, therapy-associated polyposis (TAP) has emerged as a potential side effect of cancer therapy in children and young adults, potentially associated with an increased risk of gastrointestinal (GI) cancer later in life. However, only 8 cases of TAP in cancer survivors have been reported and the link between cancer treatment and polyposis is poorly understood. To clarify the link between cancer treatment and polyposis in young patients, recent multi-institutional cohort study evaluated patients from 8 cancer registries that had been diagnosed and treated for cancer before the age of 30 in an attempt to identify patients with potential TAP, which was defined as cumulative lifetime incidence of 10 or more GI polyps occurring anywhere along the GI tract in patients with a history of prior chemotherapy or radiation treatment.

The studied identified 34 patients with TAP, the majority of whom (82%) had initially been treated for Hodgkin lymphoma. The median lifetime aggregate of polyps was 32, with 35% of patients having 50 or more colorectal polyps. The median age at which GI polyps were detected was 49 years, and occurring at a median 27 years post-cancer treatment. A total of 59% of patients had received prior treatment with an alkylating agent, 62% had received abdominopelvic radiation, and 35% had been treated with both modalities. Among evaluated patients, prior abdominopelvic radiotherapy was associated with earlier development of GI polyps.

The investigators concluded cancer treatment in children and young adults is associated with an increased risk of developing polyposis that may lead to development of GI cancers later in life, regardless of family history. Young cancer survivors should be aware of this risk and undergo routine screening for development of polyps.

Read more about this article on Medscape Medical News.

Cancer Prev Res. 2020 Feb 12. [Epub ahead of print.]
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