Beyond Expert Opinion: Progress in the Development of Evidence-Based Screening Guidelines for Survivors of Childhood Cancer

In this issue of the Journal, Teepen et al. provide important new findings from the Dutch DCOG‐LATER study that support early surveillance strategies to reduce the burden of colorectal cancer (CRC) in childhood cancer survivors (1). This is of particular importance because second cancers are the greatest cause of premature mortality in adult survivors of childhood cancer. The British Childhood Cancer Survivor Study, for example, found that gastrointestinal malignancies contributed the greatest absolute excess risk among childhood cancer survivors older than age 40 years, and the cumulative incidence of CRC for survivors treated with abdominopelvic radiotherapy (RT) was 1.4% by age 50 years (2). This and other large cohort studies have demonstrated that platinum-based chemotherapy and abdominal or pelvic RT increase CRC risk up to three to four times higher than expected (3).

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