Young Adult Cancer Survivors Face Double the Risk of Secondary Cancers

Survivors of cancer diagnosed during their teenage and young adult years face a significantly higher risk of developing new malignancies later in life. According to research from Alberta published in the Canadian Medical Association Journal (CMAJ), these individuals are at double the risk of most types of later cancers compared to the general population.

This increased susceptibility highlights a critical challenge in oncology: while survival rates for adolescents and young adults (AYA) are high, the long-term effects of the disease and its treatment can persist for decades.

Understanding the Alberta Adolescent and Young Adult Cancer Survivor Study

The findings stem from the Alberta Adolescent and Young Adult Cancer Survivor Study, a comprehensive analysis spanning 34 years. The study tracked individuals in Alberta aged 15 to 39 who were diagnosed with their first cancer between 1983 and 2017.

Of the 24,459 participants included in the study, researchers found that 1,442 people—approximately 6% of the cohort—developed at least one subsequent cancer during a median follow-up period of 7.4 years.

Which Cancers Are Most Common?

The research identified specific patterns in both the initial diagnosis and the subsequent cancers that developed:

• Initial Cancers: Lymphoma and breast cancer were the most common primary diagnoses after which later cancers developed.
• Subsequent Cancers: Breast, colorectal, and lung cancers were the most frequent new malignancies, accounting for 43% of all subsequent primary neoplasms.

The Role of Primary Neoplasms and Treatment Effects

In medical terms, these new cancers are known as primary neoplasms. These are not recurrences of the original cancer but entirely new malignancies that develop after an earlier cancer has been treated.

Primary neoplasms are recognized as a “late effect” of previous cancers. This heightened risk is often attributed to the effects of the treatments used to cure the first cancer. Dr. Miranda Fidler-Benaoudia, a cancer epidemiologist at the University of Calgary Cumming School of Medicine and Cancer Care Alberta, notes that with survival rates for this age group at approximately 86%, there is a growing population of survivors who may be adversely affected by their diagnosis and treatment decades later.

The Importance of Long-Term Monitoring

As the risk of secondary cancers is significantly elevated for those diagnosed during their formative years, healthcare providers emphasize the need for personalized, long-term follow-up care. The risk is influenced by several variables, including:

• The specific type of primary cancer.
• The age at the time of the initial diagnosis.
• The specific treatments received.
• Genetic predispositions and lifestyle factors.

According to the American Cancer Society, the AYA category includes people diagnosed between the ages of 15 and 39. While cancer typically occurs in older adults—with only about one in 20 cancer patients being a young adult aged 20-39—the long-term health trajectory for these survivors requires diligent medical surveillance.

Key Takeaways for AYA Survivors

Frequently Asked Questions

What is a primary neoplasm?

A primary neoplasm is a new, independent cancer that develops in a survivor after they have already been treated for a previous, different cancer.

Why do young survivors have a higher risk of secondary cancers?

The increased risk is often a late effect of the treatments used to fight the initial cancer, though genetic factors and the type of original cancer also play a role.

Who is considered an “adolescent or young adult” (AYA) in cancer research?

The AYA category generally includes individuals who are diagnosed with cancer between the ages of 15 and 39.