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December 22/29, 2020

Incorporating the Risk for Subsequent Primary Cancers Into the Care of Adult Cancer Survivors: Moving Beyond 5-Year Survival

Author Affiliations
  • 1Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California
  • 2Department of Medicine (Hematology/Oncology), David Geffen School of Medicine at UCLA, Los Angeles, California
  • 3UCLA Jonsson Comprehensive Cancer Center, Los Angeles, California
  • 4Department of Pediatrics (Hematology/Oncology), David Geffen School of Medicine at UCLA, Los Angeles, California
JAMA. 2020;324(24):2493-2495. doi:10.1001/jama.2020.23410

A diagnosis of cancer is a feared and often unexpected event, affecting an estimated 1.8 million individuals annually in the US.1 Hereditary cancers are rare, accounting for approximately 10% of all incident cancers.2 The majority of adult-onset cancers are sporadic, increase with advancing age, and are associated with lifestyle behaviors, obesity, and infections that lead to acquired somatic mutations that eventuate in cancer, accounting for an estimated 50% to 60% of incident cancers.3 Cancer is often diagnosed early with screening tests, or when more advanced, is identified because of clinical symptoms or findings on physical examination. Given treatment advances and novel therapeutic approaches, some advanced cancers can be cured with contemporary treatment regimens. Among patients who survive a primary cancer, concern about recurrence, especially metastatic disease, is extremely common; however, information about future risk for subsequent primary cancers (SPCs) is seldom communicated to these patients, leading to missed opportunities to prevent or detect SPCs at an early stage.