Subsequent Malignant Neoplasms in Childhood Cancer Survivors: Identifying Risks and Screening Recommendations

A subsequent malignant neoplasm (SMN) is defined as a distinctly new histologic malignant neoplasm that occurs after completion of treatment of a primary malignancy or hematopoietic stem cell transplant. The risk for SMNs in survivors is estimated to be between 2% and 20%. Many risk factors associated with the development of SMNs including radiation, chemotherapy, underlying genetic diagnoses, and lifestyle factors, which all must be understood to provide appropriate SMN screening recommendations for survivors. Many different screening guidelines exist-choosing the appropriate set for each patient requires an understanding of all factors that impact individualized SMN risk.