Risk of developing a subsequent primary cancer varied significantly by age at initial diagnosis, sex, and type of first cancer, according to a study by Oxana Palesh and Susan Hong and colleagues at Virginia Commonwealth University, U.S., published April 28th in the open-access journal PLOS Medicine.
Advances in cancer detection and treatment have led to a growing population of cancer survivors. In the U.S., the number of cancer survivors is expected to grow by 22% over the next decade— from 18 million in 2025 to more than 22 million by 2035. Survivors remain at higher risk for developing new primary cancers distinct from their original diagnosis. This risk may be influenced by factors such as older age, exposure to radiation and/or chemotherapy and ongoing lifestyle factors like smoking, obesity and poor diet. Understanding who is at greater risk and how this risk changes over time can help to inform prevention and monitoring strategies.
Using retrospective data from more than 3 million cancer survivors in the U.S., researchers examined how demographic factors and cancer characteristics correlate with subsequent cancer risk. Several factors were associated with developing a subsequent cancer, including older age at initial diagnosis and male sex. In addition, survivors of lung, bladder, and skin melanoma were at higher risk of developing new cancer.
These findings reinforce the importance of long‑term survivorship care and risk‑based monitoring. By identifying survivor groups at heightened risk, studies like this can help to inform tailored prevention strategies, surveillance guidelines, and survivorship care planning as the cancer survivor population continues to grow.
First author Hui Cheng adds, "By examining nearly five decades of national data, we found population-level shifts in subsequent primary cancer risk, with several survivor groups experiencing rising risks. These findings can help design more tailored surveillance and prevention strategies."
In your coverage, please use this URL to provide access to the freely available paper in PLOS Medicine: https://plos.io/4lZjpzL
Citation: Cheng HG, Aduse-Poku L, McGill C, Palesh O, Hong S (2026) Subsequent primary cancer incidence among cancer survivors in the United States, 1975–2019: An age–period–cohort analysis. PLoS Med 23(4): e1005034. https://doi.org/10.1371/journal.pmed.1005034
Author countries: United States of America
Funding: This work was supported by the US National Cancer Institute (R01CA239714, R01CA172145, and R01CA226080 to OP). Additional support was provided by the National Cancer Institute (P30CA016059 to the Massey Comprehensive Cancer Center), which supplied infrastructure and shared resources used by the authors in conducting this study. The funding agencies and sponsors had no role in the design or conduct of the study; in the collection, management, analysis, or interpretation of the data; in the preparation, review, or approval of the manuscript; or in the decision to submit the manuscript for publication.
