Second primary cancers after childhood cancer: low absolute risk, but prevention and monitoring are high priorities.(Editorial)

Over the past two decades, impressive advances have been made in the treatment and survival of children with cancer. Population based data from the United States document a 68% five year survival for children aged 0-15 years who were diagnosed with cancer in 1985.(1) In the vast majority of cases, five year survival represents cure. Accordingly, the number of children and young adults in the population who have been exposed to cancer treatments, which often include radiation and chemotherapy, continues to increase. These children, cured of their cancer, are at risk from adverse effects of the treatment they received.

Little is known about the long term consequences of cancer treatment. Rapid improvements in the treatment and survival of children with cancer were first realised in the early 1970s, and therefore the first large cohort of survivors of childhood cancer is now entering adulthood, a decade or more after being treated. A retrospective cohort of children in Britain diagnosed with cancer since 1940 has provided an opportunity to …