Charlotte Demoor-Goldschmidt, Delphine Drui, Isabelle Doutriaux, Gérard Michel, Pascal Auquier, Agnès Dumas, Claire Berger, Valérie Bernier, Sandrine Bohrer, Pierre-Yves Bondiau, Bruno Filhon, Brice Fresneau, Claire Freycon, Dinu Stefan, Sylvie Helfre, Angela Jackson , Christine Kerr, Anne Laprie, Julie Leseur, Marc-André Mahé, Caroline Oudot, Claire Pluchard, Stéphanie Proust, Hélène Sudour-Bonnange, Céline Vigneron, Nathalie Lassau, Martin Schlumberger, Cécile Faure Conter and Florent de Vathaire.
BMC Cancer. 2017 May 12;17(1):326.
https://pubmed.ncbi.nlm.nih.gov/28499444/
Background
Survival of childhood, adolescent and young adult (CAYA) cancers has increased with progress in the management of the treatments and has reached more than 80% at 5 years. Nevertheless, these survivors are at great risk of second cancers and non-malignant co-morbidities in later life. DeNaCaPST is a non-interventional study whose aim is to organize a national screening for thyroid cancer and breast cancer in survivors of CAYA cancers. It will study the compliance with international recommendations, with the aim, regarding a breast screening programme, of offering for every woman living in France, at equal risk, an equal screening.
Method
DeNaCaPST trial is coordinated by the INSERM 1018 unit in cooperation with the LEA (French Childhood Cancer Survivor Study for Leukaemia) study’s coordinators, the long term follow up committee and the paediatric radiation committee of the SFCE (French Society of Childhood Cancers). A total of 35 centres spread across metropolitan France and la Reunion will participate. FCCSS (French Childhood Cancer Survivor Study), LEA and central registry will be interrogated to identify eligible patients. To participate, centers agreed to perform a complete « long-term follow-up consultations » according to good clinical practice and the guidelines of the SFCE (French Society of Children Cancers).
Discussion
As survival has greatly improved in childhood cancers, detection of therapy-related malignancies has become a priority even if new radiation techniques will lead to better protection for organs at risk. International guidelines have been put in place because of the evidence for increased lifetime risk of breast and thyroid cancer. DeNaCaPST is based on these international recommendations but it is important to recognize that they are based on expert consensus opinion and are supported by neither nonrandomized observational studies nor prospective randomized trials in this specific population. Over-diagnosis is a phenomenon inherent in any screening program and therefore such programs must be evaluated.
Keywords: Breast; Breast cancer screening; Childhood cancer; Childhood cancer survivor; Second cancer; Secondary cancer; Survivor; Thyroid; Thyroid cancer screening.