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Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery

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Rising Risk of Subsequent Primary Cancers Among US Cancer Survivors, 2000-2021.

Hui G Cheng¹, Livingstone Aduse-Poku¹, Oxana Palesh¹

¹Massey Comprehensive Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA.

Cancer Medicine

|April 6, 2026

Summary

This summary is machine-generated.

Subsequent primary cancer (SPC) risk significantly increased in US cancer survivors from 2000-2020. This rise underscores the urgent need for improved surveillance and survivorship care strategies for cancer patients.

Keywords:

SEER cancer survivors epidemiology multiple primary cancers standardized incidence ratio survivorship time trends

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Area of Science:

Oncology
Cancer Epidemiology
Public Health

Background:

Improving cancer survival rates lead to a growing population at risk for subsequent primary cancers (SPCs).
Current trends in SPC incidence are not well-understood, hindering the development of effective surveillance and survivorship plans.

Purpose of the Study:

To analyze long-term trends in SPC risk among cancer survivors in the United States.
To identify specific subgroups of survivors at higher risk for SPCs based on cancer type and demographics.

Main Methods:

A retrospective cohort study utilizing data from 17 SEER registries, including over 6 million individuals diagnosed with a primary cancer between 2000 and 2021.
Standardized incidence ratios (observed-to-expected ratios) and Cox proportional hazards models were employed to assess SPC trends.
Analyses were stratified by cancer site, latency, stage, age, sex, and race/ethnicity.

Main Results:

SPC risk saw a substantial increase between 2000 and 2020, with observed-to-expected ratios rising significantly for both men and women.
The highest incidence of SPCs was observed within six months following the initial cancer diagnosis.
Significant variations in SPC risk were noted across different demographic factors and cancer-related characteristics.

Conclusions:

The increasing incidence of SPCs highlights a critical gap in current cancer survivorship care.
Findings support the necessity for updated, risk-stratified surveillance protocols.
Results can inform national cancer control strategies to mitigate long-term morbidity in cancer survivors.