Study Finds Risk of Second Cancers in Childhood Cancer Survivors Has Gone Down Over Time

Lower Risk Linked to Decreases in Radiation Treatment

little girl with cancer smiles

A new study shows that the risk of developing a second cancer is lower for survivors who were diagnosed with childhood cancer in the 1990s than for those diagnosed in the 1970s. During this same time, the proportion of children receiving radiation decreased. And for those who did get radiation, doses were lower.

The study by researchers from cancer centers in the US and Canada was published February 28 in the Journal of the American Medical Association.

Today, because of advances in treatment, a high percentage of children diagnosed with cancer will live into adulthood. However, the treatments that help these children survive their cancer also raise their risk for health problems later on. These health problems may include developing another cancer.

Radiation treatment has long been linked with the risk of new tumors later in life. Therefore, treatment of childhood cancer has changed over time to reduce the amount of radiation given, while maintaining or improving survival.

The researchers looked at the records of 23,603 people who were diagnosed with cancer at an average age of 7.7 years. They followed them for an average 20.5 years. Those diagnosed in the 1970s had a 2.1% risk of developing a second cancer after 15 years, compared with 1.3% for those diagnosed in the 1990s. The most common second cancers were breast and thyroid cancers.

In the 1970s, the proportion of child cancer patients receiving radiation was 77%, compared with 33% in the 1990s. The study authors note that the lower risk of getting a second cancer was linked to this reduction in radiation.

Late effects of childhood cancer treatment

Because more children with cancer now survive into adulthood, the long-term health problems from cancer treatment, called late effects, has become a focus of research and of care. Experts recommend:

  • Going to all follow-up visits recommended by your health care team
  • Reporting any symptoms, including pain, tiredness, and anxiety
  • Keeping copies of medical records including pathology reports, surgery reports, hospital discharge summaries, drug and radiation doses, imaging tests, and health care providers’ contact information

More information is available from the Children’s Oncology Group, the world’s largest group of doctors and other health professionals devoted to treating cancer in children and teens.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Temporal Trends in Treatment and Subsequent Neoplasm Risk Among 5-Year Survivors of Childhood Cancer, 1970-2015. Published February 28, 2017 in the Journal of the American Medical Association. First author Lucie M. Turcotte, MD, MPH, MS, University of Minnesota Medical School, Minneapolis.

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