June 1, 2026
By Tammy McCausland
Progress in early detection and advances in treatment have produced a growing population of cancer survivors who are living longer, an achievement celebrated each June during National Cancer Survivors Month. In the United States today, that group totals more than 18 million people, according to the American Association for Cancer Research.1 By 2035, the number of survivors in America will top an estimated 22 million.2
For the youngest in that group—those first diagnosed as children or young adults—survival frequently comes with a heavy burden. While all cancer survivors face a 16 percent higher risk of developing new cancers compared to the general population,3 two recent studies show that survivors who began treatment in the years between infancy and age 39 live with a significantly higher risk.4,5
As with survivors of adult cancer, some portion of that risk likely stems from the genetic predisposition that may have contributed to their original cancer, as well as from lifestyle factors adopted as these younger survivors age. However, research indicates that the greater contributor is related to the radiation or chemotherapy treatments they received for their first occurrence of cancer.
Digging deeper into the correlation between childhood cancer treatments and later diagnoses of new cancers, scientists at St. Jude Children’s Research Hospital found a direct molecular connection in second neoplasm tissue samples from survivors enrolled in the Childhood Cancer Survivor Study.6 Comparing genetic sequences from those samples to similar cancer tissue drawn from the general population uncovered distinct mutational patterns tied to specific cancer therapies.
According to Samuel W. Brady, the study’s corresponding author, this research will ideally help to find ways to reduce the risks of cancer treatments, as well as to improve screening protocols to catch secondary cancers earlier.7
Recommended screening protocols already urge earlier testing for survivors of childhood, adolescent and young adult cancer. The Children’s Oncology Group provides long-term follow-up guidelines for survivors of all types of cancer.8
For instance, they note that women who, as children, received total body irradiation or radiation therapy to the chest or underarm may develop breast cancer much earlier, and should begin yearly breast exams at puberty, with yearly mammograms coupled with breast MRI commencing eight years after radiation or at age 25, whichever comes later. The guidelines also suggest early colorectal screening for childhood cancer survivors who received total body irradiation or radiation therapy to the abdomen, pelvis or spine.
Yet despite the known risks of developing new cancers, many of the survivors in these three younger age groups add to that likelihood with risky choices as they age. More than 70 percent of survivors at risk for colorectal cancer forgo screening.8 Childhood cancer survivors smoke at nearly twice the rate of their cancer-free peers.9
While work continues to try to lessen any delayed consequences produced by cancer treatments, education and counseling are crucial to help these survivors understand how they can improve their chances of detecting a new cancer early, or even avoid that diagnosis altogether.
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