儿童癌症幸存者 (CCS) 患角化细胞癌 (KC) 的风险增加，但是，单发和多发 KC 的长期发病率尚未明确。识别风险因素并量化 CCS 中 KC 累积发病率和多发病负担是在儿童癌症幸存者研究参与者中确定的，这是一群 1970 年至 1999 年间在北美被诊断出年龄 <21 岁的五年癌症幸存者。估计了累积发生率，多变量模型评估了与幸存者和治疗特征相关的 KC 相对发生率。在 25,658 名参与者中，1,446 人发展了 5,363 KC（93.5% 为基底细胞癌，6.7% 为鳞状细胞癌；平均年龄 37.0 岁（范围 7.3-67.4 岁） ），平均潜伏期 25.7 年；白人为 95.3%，放射治疗为 88.4% [RT]）。平均病变数为 3.7，其中 26.1% 的病变数≥4。 RT 使任何 KC 的发生率增加 4.5 倍，使 ≥4 KC 的发生率增加 9.4 倍。同种异体和自体造血细胞移植分别与 KC 率增加 3.4 倍和 2.3 倍相关。参与者自我报告的一些数据（包括没有皮肤照片类型的种族和既往病史）可能会影响分析。CCS 中 KC 的负担仍然很高，但可预测的风险因素应该指导筛查。版权所有 © 2024。由 Elsevier Inc. 出版。

Childhood cancer survivors (CCS) are at increased risk for keratinocyte carcinomas (KC) however, the long-term incidence of single and multiple KC is not well established.Identify risk factors and quantify KC cumulative incidence and multiple-incidence burden in CCS.KC were identified among Childhood Cancer Survivor Study participants, a cohort of five-year cancer survivors diagnosed <21 years of age between 1970-1999 in North America. Cumulative incidence was estimated, and multivariable models assessed relative rates of KC associated with survivor and treatment characteristics.Among 25,658 participants, 1,446 developed 5,363 KC (93.5% basal cell carcinoma, 6.7% squamous cell carcinoma; mean age 37.0 years (range 7.3-67.4), mean latency 25.7 years; 95.3% White and 88.4% with radiotherapy [RT]). Mean lesion count was 3.7 with 26.1% experiencing ≥4. RT imparted a 4.5-fold increase in the rate of any KC and 9.4-fold increase in the rate of ≥4 KC. Allogeneic and autologous hematopoietic cell transplant were associated with a 3.4- and 2.3-fold increased rate of KC, respectively.Participant self-reporting of some data including race without skin phototype and past medical history may have impacted analysis.The burden of KC in CCS remains high, but predictable risk factors should guide screening.Copyright © 2024. Published by Elsevier Inc.