ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2025
Secondary Lung Cancer among Survivors of Adolescent and Young Adult Cancer: A Population-Based Study.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSurvivors of adolescent and young adult (AYA, ages 15-39 years at diagnosis) cancer are at increased risk for subsequent malignant neoplasms (SMN), of which lung cancer is the most lethal. Factors contributing to lung SMN development and outcomes are not well characterized.
methodsSurvivors of AYA cancer diagnosed between 1998 and 2020 were identified in the California Cancer Registry (n = 251,632). Pearson's χ2 and Fisher's exact tests were used to determine associations between sociodemographic and cancer characteristics and SMN status. Multivariable Cox proportional hazard regression, adjusting for age, time from primary diagnosis, race/ethnicity, insurance, primary cancer site, stage, and treatment, evaluated associations between these characteristics and the incidence and mortality of lung cancer as first SMN.
resultsA total of 675 (0.7%) survivors were diagnosed with lung SMN, of whom 487 (72.1%) died. The median time from primary diagnosis to lung SMN was 13.0 years (IQR 4.0-20.0 years). Nearly half (46.5%) of survivors with lung SMN had metastatic disease. Non-Hispanic Black survivors were more likely than non-Hispanic White survivors to develop lung SMN [adjusted HR (aHR) = 1.47; 95% confidence interval (95% CI), 1.13-1.91] but were not more likely to die from lung SMN (aHR = 0.84; 95% CI, 0.56-1.27). Primary cancer treatment with both chemotherapy and radiation was associated with a greater likelihood of lung SMN (aHR = 1.41; 95% CI, 1.11-1.80) compared with receiving neither.
conclusionsLung SMN has a long latency and high mortality among survivors of AYA cancer. IMPACT: More research is needed on lung cancer prevention, education, and early detection, particularly among survivors at higher risk.
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