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3144 S urvivors of adolescent and young adult (AYA) cancer have a higher risk of developing and dying of a new primary cancer in comparison with the general population according to new research published in the Journal of the National Cancer Institute.1 According to lead study author Hyuna Sung, MD, principal scientist for cancer surveillance research at the American Cancer Society, although the risk of cancer has been extensively studied among childhood cancer survivors, little is known about the risk of cancer in AYA cancer survivors. The new findings come from an analysis of 170,000 individuals in nine Surveillance, Epidemiology, and End Results registries who survived for 5 years after their initial cancer diagnosis, which occurred between 1975 and 2013. The researchers found that 35 years after the initial cancer diagnosis, one in seven survivors developed new cancer, and one in 16 survivors died of new cancer. In comparison with the general population, the risk among survivors overall was 25% higher for cancer incidence (95% CI, 1.23–1.27; absolute excess incidence, 10.8 per 10,000) and 84% higher for cancer death (95% CI, 1.79–1.89; absolute excess mortality, 9.2 per 10,000). “These results strongly stress the need to expand research on and strengthen efforts for surveillance of subsequent cancers among childhood and AYA cancer survivors, as well as to develop age-specific, exposure-based, and risk-stratified prevention strategies in this growing population of survivors,” said Dr Sung in a press statement. According to Michael Roth, MD, codirector of the AYA program and director of the Childhood Cancer Survivorship Program at The University of Texas MD Anderson Cancer Center in Houston, who was not involved with the research, the study highlights the importance of ensuring that all AYA cancer survivors have access to risk-adapted survivorship care with a focus on timely cancer screening and prevention. “We have evidence-based, effective screening tools for early detection of breast cancer, lung cancer, and colorectal cancer; however, few AYA cancer survivors receive the screening on the recommended schedule,” he says. “Detection of subsequent primary cancers in AYA survivors at earlier stages is associated with improved survival outcomes, further emphasizing the importance of increasing uptake of cancer screening in this population. Given AYA survivors’ high risk of developing subsequent cancers, we need to do a better job with cancer prevention, focusing survivorship care on increasing HPV [human papillomavirus] vaccination, smoking prevention/ cessation, and management of obesity. A cancer diagnosis during the AYA years impacts patients’ health and well-being for the rest of their lives. We need to ensure that they receive life-long, high-quality survivorship care to maximize their health and survival.”