Researchers studying cancer survivors over a 34-year period observed that adolescent and young adult survivors of cancer were at a heightened risk of primary neoplasms – new cancers that develop after earlier cancers.
The Alberta Adolescent and Young Adult Cancer Survivor Study included all people in Alberta aged 15 to 39 years diagnosed with a first cancer between 1983 and 2017. In this 34-year study period, researchers analysed risks of future cancers, focusing on better understanding of the impact and risks of future disease and death.
Of the 24,459 people included with a median follow-up of 7.4 years, 1442 (6%) developed at least one subsequent cancer. Hodgkin lymphoma and breast cancer were the most common types of cancer that saw primary neoplasms develop. The most common types of new cancer that were diagnosed were breast, lung and colorectal, representing 43% of cases.
Primary neoplasms are known to occur after earlier cancers, often as a result of treatment
“Although people with nearly all types of adolescent and young adult cancer investigated were at an increased risk of developing a subsequent primary neoplasm, survivors of Hodgkin lymphoma and breast cancer were identified as particularly vulnerable populations, with nearly one-third of subsequent primary neoplasms occurring after 5-year survival diagnosed in these survivor groups,” wrote Dr. Miranda Fidler-Benaoudia, a cancer epidemiologist at the University of Calgary Cumming School of Medicine and Cancer Care Alberta, Calgary, Alberta, with coauthors.
“These findings are consistent with previous studies and reflect the established late effects of radiotherapy, chemotherapy, and hormone therapy.”
Genetic factors were also believed to influence the rate of primary neoplasms and the paper noted that genetic counselling and education are an important part of care for survivors.
The paper advocates for earlier screening
Up to thirty years after their initial diagnosis as teens or young adults, 1 in 6 survivors will be diagnosed with a new cancer – often still decades before the general population.
“Our findings suggest that earlier cancer surveillance in this population may be warranted, which agrees with numerous survivorship guidelines that recommend earlier breast and colorectal cancer surveillance for at-risk cancer survivors,” the authors write.
Cancer rates in young people in Canada are rising, but rates of survival remain high
Increased rates of cancer in young people, and a high rate of survival, means there is a growing community of survivors that face the consequent increased risk of primary neoplasms, as the paper notes.
“When combined with the relatively high survival rates in this age range, at approximately 86%, there is a growing population of young cancer survivors that will be adversely affected by their cancer diagnosis and its treatment even decades later,” said the authors of the research, published in CMAJ (Canadian Medical Association Journal).
“Given that subsequent primary neoplasms are major contributors to morbidity and premature mortality, these findings underscore the need for innovative solutions to prevent, detect, and treat subsequent primary neoplasms among survivors of adolescent and young adult cancer,” the authors conclude.
Team Health Accessible
Health & Wellness Editorial Team
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