Screening for second primary cancers

Significant improvements in early detection and advances in cancer treatment in the past few decades have resulted in increasing numbers of cancer survivors. Given the major improvements in survival rates and durations, identification and characterization of the late sequelae of cancer and its treatment have become critical. It is well known that cancer survivors are at risk for recurrence of the primary cancer. The risk of developing a second primary cancer (SPC) is also increased. In view of the increasing number of cancer survivors, the development of SPCs has emerged as a significant problem that can affect quality of life and long-term survival. In addition to recurrence of the primary cancer, the diagnosis of a new cancer represents one of the most serious events experienced by cancer survivors. Interest in this area has increased owing to the potential for reducing the risk for SPCs through an understanding of genetic predispositions; lifestyle, behavioral, and environmental factors; and treatment-related effects that influence the development of SPCs. An understanding of the risks for SPCs can guide risk reduction strategies and cancer screening recommendations, with the goal of preventing SPCs or providing early detection and intervention.