Researchers who studied cancer survivors for 34 years observed that adolescent and young adult cancer survivors were at increased risk for primary neoplasms (new cancers that develop after an earlier cancer).
The Alberta Adolescent and Young Adult Cancer Survivors Study includes all people in Alberta aged 15 to 39 who were diagnosed with a first cancer from 1983 to 2017. During this 34-year study period, researchers analyzed future cancer risks, with a focus on better understanding the impact and risk of future disease and mortality.
Of 24,459 people with a median follow-up of 7.4 years, 1,442 (6%) developed at least one subsequent cancer. Hodgkin lymphoma and breast cancer were the most common types of cancer in which primary neoplasms occurred. The most common types of newly diagnosed cancer were breast, lung, and colorectal cancer, accounting for 43% of cases.
Primary neoplasms are known to develop after early cancer, often as a result of treatment
“Although nearly all types of cancer in adolescents and young adults studied had an increased risk of subsequently developing a primary neoplasm, survivors of Hodgkin’s lymphoma and breast cancer were identified as a particularly vulnerable population, with nearly one-third of subsequent primary neoplasms occurring in these survivor groups after being diagnosed for five years,” wrote Dr. Miranda Fidler-Benaudia, a cancer epidemiologist at the University of Calgary’s Cumming School of Medicine and Cancer. Care Alberta, Calgary, Alberta, with co-authors.
“These findings are consistent with previous studies and reflect the well-established late effects of radiotherapy, chemotherapy, and hormone therapy.”
Genetic factors are also thought to influence the incidence of primary neoplasms, and the paper notes that genetic counseling and education are important parts of survivor care.
This paper advocates early screening
Up to 30 years after their initial diagnosis as a teenager or young adult, 1 in 6 survivors will be diagnosed with a new cancer, often still decades earlier than the general population.
“Our findings suggest that early cancer surveillance in this population may be warranted, and are consistent with many survivorship guidelines that recommend early breast and colorectal cancer surveillance for at-risk cancer survivors,” the authors wrote.
Cancer rates are rising among Canadian youth, but survival rates remain high
As the paper points out, increased cancer incidence and higher survival rates among young people mean that a growing community of survivors face an increased risk of primary neoplasms as a result.
“Combined with the relatively high survival rate of approximately 86% in this age group, there is a growing population of young cancer survivors who are adversely affected by cancer diagnosis and its treatment even decades later,” the authors of the study published in CMAJ (Canadian Medical Association Journal).
“Given that subsequent primary neoplasms are a major cause of morbidity and early mortality, these findings highlight the need for innovative solutions for the prevention, detection, and treatment of subsequent primary neoplasms in adolescent and young adult cancer survivors,” the authors conclude.
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