Abstract B022: Trends in the Cumulative Incidence of Second Primary Cancers Among Survivors of Early-Onset Cancer in the United States, 1975-2022
Bibliographic record
Abstract
Abstract Introduction: Survivors of a first primary cancer (FPC) have a higher risk of developing a second primary cancer (SPC) compared to the general population, potentially driven by shared etiologic factors, genetic susceptibility, treatment-related effects, or heightened surveillance and screening. However, this elevated risk has not been well-characterized in the context of the rising incidence rate of adult early-onset cancers. Methods: Using data from 9 cancer registries in the U.S. from 1975 to 2022 in the Surveillance, Epidemiology, and End Results (SEER) Program, we estimated 5-year cumulative incidence of invasive SPC among those diagnosed with invasive FPC and the average annual percent change (AAPC) by age at FPC diagnosis (18-29, 30-49, 50-59, 60-69, 70-79, 80+), and examined these trends by sex and race/ethnicity. Results: Among FPC survivors, the age-standardized 5-year cumulative incidence of SPC steadily increased from 4.10 [3.90, 4.29]% to 6.54 [6.38, 6.69]% with AAPC of 1.12 [1.03, 1.20]% during the study period. The cumulative incidence increased across all age groups at FPC diagnosis. Among early-onset cancer survivors (i.e., those with FPC diagnosis at age 18-49 years old), female individuals had a higher SPC cumulative incidence than male individuals over the study period. However, the increase over time was steeper among males (e.g., for age 30-49 years old, AAPC: 1.59 [1.20, 1.98]% vs. 0.57 [0.37, 0.78]%), making the cumulative incidences similar in males and females by the end of the study period. Among those with FPC diagnosis at age 30-49 years old, the SPC cumulative incidence increased for all racial/ethnic groups, but the increase was steeper for Hispanic and non-Hispanic (NH) Asian or Pacific Islander (API) individuals compared to NH Black and NH White individuals. Notably, NH API individuals had a higher AAPC at this age group than at older age groups, a pattern unique to this racial/ethnic group. Among those with FPC diagnosis at age 18-29 years old, the trends were inconsistent across racial and ethnic groups, with positive AAPC for NH White individuals (1.93 [1.35, 2.51]%) and negative AAPC for Hispanic individuals (-2.59 [-4.26, -0.89]%). Conclusion: For nearly five decades, the burden of SPC following early-onset cancer has risen steadily across demographic groups. These trends suggest a compounded burden of cancer for more recent generations, who face an elevated risk of both an early-onset first cancer and a subsequent cancer, which may also occur at a young age. Potential drivers of these patterns, including improved survival, harmful treatment effects, and other etiologic factors, should be investigated in future research. Citation Format: Sunyeop Lee, Erica J. Lee Argov, Parisa Tehranifar. Trends in the Cumulative Incidence of Second Primary Cancers Among Survivors of Early-Onset Cancer in the United States, 1975-2022 [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: The Rise in Early-Onset Cancers—Knowledge Gaps and Research Opportunities; 2025 Dec 10-13; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(23_Suppl):Abstract nr B022.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".