Registry-based Surveillance for Second Cancer Risks
The last several decades have seen dramatic improvements in cancer survival, mainly due to advances in treatment and the increased detection of cancer at an early stage. With more than 16 million cancer survivors in the U.S. alone, concern has turned to potential late effects, particularly the development of a new malignancy. To identify groups of cancer survivors that are at increased risk for multiple primary cancers, investigators in DCEG have been leading a series of studies using registry data to monitor second cancer risks in a range of survivor populations.
The foundation of the research is a comprehensive population-based analysis of the risk of subsequent cancer in the U.S. [See New Malignancies Among Cancer Survivors: SEER Cancer Registries, 1973-2000 (Curtis RE, Freedman DM, Ron E, Ries LAG, Hacker D, Edwards B, Tucker P, Fraumeni JF, Jr., eds.) National Cancer Institute. NIH Publication No. 05-5302. Bethesda, MD, 2006 (available at SEER Monograph)]. The 500-page monograph utilized data from nine cancer registries participating in the Surveillance, Epidemiology, and End Results (SEER) Program from 1973 to 2000. The monograph describes the patterns of subsequent cancer risk for over 50 adult first primary cancers and 19 types of childhood cancers, by sex, age at initial diagnosis, time since diagnosis, initial treatment by radiation, and histologic type. Each chapter focuses on a specific initial cancer, presents the risk of subsequent cancers, and discusses potential causal mechanisms.
Additional studies have quantified contralateral breast cancer risk, breast cancer after Hodgkin lymphoma, melanoma after non-Hodgkin lymphoma, sarcoma risk after young adulthood cancers, and leukemia risk after chemotherapy for solid tumors and lymphoid malignancies among adult and childhood cancer survivors. The data from the monograph and these studies provide a resource that will be useful to clinicians, researchers, policy makers, and cancer survivors, especially in tailoring appropriate guidelines and strategies for prevention and early detection of new malignancies.
For more information, contact Lindsay Morton.