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JNCI Journal of the National Cancer Institute 2006 98(1):15-25; doi:10.1093/jnci/djj001
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© The Author 2006. Published by Oxford University Press.

COMMENTARY

Cancer Survivorship—Genetic Susceptibility and Second Primary Cancers: Research Strategies and Recommendations

Lois B. Travis, Charles S. Rabkin, Linda Morris Brown, James M. Allan, Blanche P. Alter, Christine B. Ambrosone, Colin B. Begg, Neil Caporaso, Stephen Chanock, Angela DeMichele, William Douglas Figg, Mary K. Gospodarowicz, Eric J. Hall, Michie Hisada, Peter Inskip, Ruth Kleinerman, John B. Little, David Malkin, Andrea K. Ng, Kenneth Offit, Ching-Hon Pui, Leslie L. Robison, Nathaniel Rothman, Peter G. Shields, Louise Strong, Toshiyasu Taniguchi, Margaret A. Tucker, Mark H. Greene

Affiliations of authors: Division of Cancer Epidemiology and Genetics (LBT, CSR, LMB, BPA, NC, SC, MH, PI, RK, NR, MAT, MHG), Center for Cancer Research (WDF), National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD; University of York, York, UK (JMA); Department of Epidemiology, Roswell Park Cancer Institute, Buffalo, NY (CBA); Memorial Sloan-Kettering Cancer Center, New York, NY (CBB, KO); University of Pennsylvania, Philadelphia (AD); The Princess Margaret Hospital, University of Toronto, Ontario, Canada (MKG); Center for Radiological Research, Columbia University, New York, NY (EJH); Laboratory of Radiobiology, Harvard School of Public Health, Boston, MA (JBL); The Hospital for Sick Children, Toronto, Ontario, Canada (DM); Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute (AKN), Boston, MA; St. Jude Children's Research Hospital, Memphis, TN (C-HP); University of Minnesota, Minneapolis (LLR); Lombardi Cancer Center, Washington, DC (PGS); University of Texas M. D. Anderson Cancer Center, Houston (LS); Fred Hutchinson Cancer Research Center, Seattle, WA (TT)

Correspondence to: Lois B. Travis, MD, Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch, National Cancer Institute, 6120 Executive Blvd., EPS # 7086, MSC 7238, Bethesda, MD 20892 (e-mail: travisl{at}mail.nih.gov).

Cancer survivors constitute 3.5% of the United States population, but second primary malignancies among this high-risk group now account for 16% of all cancer incidence. Although few data currently exist regarding the molecular mechanisms for second primary cancers and other late outcomes after cancer treatment, the careful measurement and documentation of potentially carcinogenic treatments (chemotherapy and radiotherapy) provide a unique platform for in vivo research on gene–environment interactions in human carcinogenesis. We review research priorities identified during a National Cancer Institute (NCI)–sponsored workshop entitled "Cancer Survivorship—Genetic Susceptibility and Second Primary Cancers." These priorities include 1) development of a national research infrastructure for studies of cancer survivorship; 2) creation of a coordinated system for biospecimen collection; 3) development of new technology, bioinformatics, and biomarkers; 4) design of new epidemiologic methods; and 5) development of evidence-based clinical practice guidelines. Many of the infrastructure resources and design strategies that would facilitate research in this area also provide a foundation for the study of other important nonneoplastic late effects of treatment and psychosocial concerns among cancer survivors. These research areas warrant high priority to promote NCI's goal of eliminating pain and suffering related to cancer.



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