Risk of subsequent gliomas and meningiomas among 69,460 5-year survivors of childhood and adolescent cancer in Europe: the PanCareSurFup study

Emma J. Heymer, Michael M. Hawkins, David L. Winter, Jop C. Teepen, Ceren Sunguc, Cécile M. Ronckers, Rodrigue S. Allodji, Daniela Alessi, Elaine Sugden, Fabiën N. Belle, Francesca Bagnasco, Julianne Byrne, Edit Bárdi, Stanislaw Garwicz, Desiree Grabow, Momcilo Jankovic, Peter Kaatsch, Melanie Kaiser, Gisela Michel, Christina SchinderaNadia Haddy, Neige Journy, Maja Česen Mazić, Roderick Skinner, Judith L. Kok, Maria W. Gunnes, Thomas Wiebe, Carlotta Sacerdote, Milena M. Maule, Monica Terenziani, Zsuzsanna Jakab, Jeanette F. Winther, Päivi M. Lähteenmäki, Lorna Zadravec Zaletel, Riccardo Haupt, Claudia E. Kuehni, Leontien C. Kremer, Florent de Vathaire, Lars Hjorth, Raoul C. Reulen*

*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review


Background: Childhood cancer survivors are at risk of subsequent gliomas and meningiomas, but the risks beyond age 40 years are uncertain. We quantified these risks in the largest ever cohort. Methods: Using data from 69,460 5-year childhood cancer survivors (diagnosed 1940–2008), across Europe, standardized incidence ratios (SIRs) and cumulative incidence were calculated. Results: In total, 279 glioma and 761 meningioma were identified. CNS tumour (SIR: 16.2, 95% CI: 13.7, 19.2) and leukaemia (SIR: 11.2, 95% CI: 8.8, 14.2) survivors were at greatest risk of glioma. The SIR for CNS tumour survivors was still 4.3-fold after age 50 (95% CI: 1.9, 9.6), and for leukaemia survivors still 10.2-fold after age 40 (95% CI: 4.9, 21.4). Following cranial radiotherapy (CRT), the cumulative incidence of a glioma in CNS tumour survivors was 2.7%, 3.7% and 5.0% by ages 40, 50 and 60, respectively, whilst for leukaemia this was 1.2% and 1.7% by ages 40 and 50. The cumulative incidence of a meningioma after CRT in CNS tumour survivors doubled from 5.9% to 12.5% between ages 40 and 60, and in leukaemia survivors increased from 5.8% to 10.2% between ages 40 and 50. Discussion: Clinicians following up survivors should be aware that the substantial risks of meningioma and glioma following CRT are sustained beyond age 40 and be vigilant for symptoms.

Original languageEnglish
JournalBritish Journal of Cancer
Pages (from-to)976-986
Number of pages11
Publication statusPublished - 6 Apr 2024


  • Adolescent
  • Adult
  • Central Nervous System Neoplasms/epidemiology
  • Europe/epidemiology
  • Glioma/epidemiology
  • Humans
  • Incidence
  • Leukemia/epidemiology
  • Meningeal Neoplasms/epidemiology
  • Meningioma/etiology
  • Middle Aged
  • Neoplasms, Second Primary/epidemiology
  • Risk Factors
  • Survivors


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