June 17, 2011
Jonathan Fish, MD
In a study that included nearly 18,000 children who had cancer, with follow-up of about 25 years, the greatest excess risk associated with a new tumor at older than age 40 years was for digestive and genital or urinary tract organs, according to the new issue of the Journal of the American Medical Association. Their risk is three- to six-fold what would typically be expected.
As children cured of cancer have survived and grown into adults, it has become clear that the cure is not the end of the journey. There are more than 350,000 survivors of childhood cancer in the US; more than two-thirds of them have a chronic illness caused by their treatment, and many have multiple medical problems. Second cancers caused by the radiation and chemotherapy used to treat the original disease are among the most serious concerns for childhood cancer survivors.
Understanding which second cancers happen, when they happen, and what treatment may have led to them are critical to designing and implementing targeted, risk-based screening programs for this high-risk population. This study contributes to this understanding.