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Second malignant neoplasms: assessment and strategies for risk reduction
Marie E Wood1, Victor Vogel, Andrea Ng
1Division of Hematology/Oncology, University of Vermont, Burlington, VT 05405, USA. marie.wood@uvm.edu
Summary
Second malignant neoplasms (SMNs) are a growing concern for cancer survivors, impacting over 16% of new cancers. Understanding their causes and developing targeted prevention strategies is crucial for improving long-term outcomes.
Area of Science:
- Oncology
- Cancer Survivorship
- Public Health
Background:
- Cancer survival rates have improved significantly due to advances in detection, care, and treatment.
- Long-term cancer survivors face risks from late effects of treatment, including second malignant neoplasms (SMNs).
- SMNs represent a growing proportion of new cancer diagnoses, approximately 1 in 6 reported to the SEER Program.
Purpose of the Study:
- To provide an overview of SMNs in adult-onset cancer survivors.
- To summarize current evidence on screening and prevention of SMNs.
- To offer guidance for healthcare providers managing cancer survivors at risk for SMNs.
Main Methods:
- Review of existing clinical evidence regarding SMNs in cancer survivors.
- Categorization of SMNs based on predominant etiologic factors (treatment-related, syndromic, shared exposures).
- Analysis of factors influencing SMN risk, including therapy, shared exposures, genetics, and environment.
Main Results:
- SMNs arise from a combination of treatment effects, shared etiologic factors (e.g., tobacco, alcohol), genetic susceptibility, and environmental exposures.
- Risk for specific SMNs can be modified by age at exposure and attained age.
- Current clinical evidence for SMN screening and prevention is limited.
Conclusions:
- The increasing incidence of SMNs necessitates further research into etiologic influences and genetic risk factors.
- Identifying high-risk groups is essential for developing targeted preventive and interventional strategies.
- Healthcare providers require updated guidance to effectively manage the risk of SMNs in cancer survivors.
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