UICC World Cancer Congress 2006

Several studies following large cohorts of childhood cancer survivors have reported a 3-6 fold increase in the risk of developing a second cancer when compared to cancer incidence in age matched controls. Unfortunately this marked predisposition appears to increase as the populations of these cohorts age. Since current overall childhood cancer cure rates exceed 75% and currently 1 in 600 individuals under the age of 40 years is a survivor of childhood cancer, improved understanding of the risk of second cancer, its mechanism(s), and developing strategies for screening and prevention are warranted. Death from a subsequent, treatment-related cancer is the second leading cause of mortality in childhood cancer survivors. Younger age at treatment of the primary cancer is associated with the highest risk of most second cancers excluding treatment-related myelodysplastic syndromes. Age, genetic syndromes, cumulative exposure to specific chemotherapy agents, and ionizing radiation exposure are all associated with specific risks of certain cancers and must be considered in developing universal screening strategies for this expanding population of children, adolescents and young adults at risk.