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We aimed to quantify the roles of radiation therapy and chemotherapy agents in the occurrence of subsequent CRC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A nested case\u2013control study was conducted using 36 CRC cases and 140 controls selected from 7032 five\u2010year survivors of the French Childhood Cancer Survivor Study (FCCSS) cohort, treated from 1945 to 2000 in France. The radiation dose\u2010distribution metrics at the site of CRC and doses of individual chemotherapeutic agents were calculated. Conditional logistic regressions were performed to calculate odds ratios (ORs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, patients who received radiotherapy with estimated dose to colon had a 4.3\u2010fold (95% CI, 1.3\u201317.6) increased risk for CRC compared with patients who did not receive radiotherapy, after adjustment for chemotherapy. This risk increased to 8.9\u2010fold and 19.3\u2010fold among patients who received radiation doses ranging from 20 to 29.99\u00a0Gy and \u226530\u00a0Gy, respectively. Our data reported a significantly elevated OR for anthracyclines, after controlling for radiotherapy and MOPP regimen. But, restricted analyses excluding patients who had received \u226530\u00a0Gy showed that only radiation doses ranging from 20 to 29.99\u00a0Gy produced a significant increase in subsequent CRC risk (OR\u00a0=\u00a07.8; 95% CI, 1.3\u201356.0), after controlling for anthracyclines and MOPP regimen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The risk of subsequent CRC was significantly increased after radiation dose (even\u00a0&lt;\u00a030\u00a0Gy). This novel finding supports the need to update monitoring guidelines for CRC to optimize the long\u2010term follow\u2010up for subsequent CRC in survivors of childhood cancer.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.27495","type":"journal-article","created":{"date-parts":[[2018,10,22]],"date-time":"2018-10-22T05:49:36Z","timestamp":1540187376000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Risk of subsequent colorectal cancers after a solid tumor in childhood: Effects of radiation therapy and chemotherapy"],"prefix":"10.1002","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1895-8415","authenticated-orcid":false,"given":"Rodrigue S.","family":"Allodji","sequence":"first","affiliation":[{"name":"Universit\u00e9 Paris\u2010Saclay Univ. 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