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Survivors are screened for second cancers on the strength of how large their risk is, not on the strength of a trial showing that screening them saves lives. For most organs there is no programme at all.
This is the sharpest gap the second-cancers facet of this round found, and it stated it in one sentence: no randomised trial has shown that any survivorship screening programme reduces death from a second cancer.
Where a programme exists, it rests on inference. The United Kingdom's very high risk breast screening protocol offers annual magnetic resonance imaging to women irradiated to the chest when young; the case for it is the size of the measured risk, the youth of the women, and general evidence that magnetic resonance imaging finds breast cancer earlier in high-risk women. It is not a trial in irradiated survivors, and, as the paediatric facet put it, there will not be one. That is a defensible decision rather than an oversight: the population is small, the latency is decades, and randomising a woman with a measured several-fold risk to no surveillance is not something an ethics committee would approve.
Where no programme exists, the reasoning has never been done at all. No country screens for lung cancer on the basis of having had chest radiotherapy, even though measured second-primary lung cancer rates in some survivor groups exceed the rate in the control arm of the trial that established that lung screening saves lives. No country screens survivors' skin as a programme. There is no bladder screening for people who have had cyclophosphamide anywhere. For adults treated as adults there is no organised colonoscopy programme after abdominal or pelvic radiotherapy in the United Kingdom, the United States or Europe. For thyroid cancer after neck radiotherapy the international guideline panel compared ultrasound against feeling the neck, found neither superior, and published a decision aid instead of a recommendation.
The reason this matters more than it looks is that a survivor cannot tell the difference between a gap and a decision. Being told there is no programme sounds like reassurance. On several of these organs it is not reassurance, it is an unanswered question, and the records on this front say which is which.
Shares Bladder cancer after cyclophosphamide, Thyroid cancer after neck radiotherapy, and whether to look for it, Skin cancer after cancer treatment, The UK very high risk breast screening protocol after chest radiotherapy and the tags rejuvenation, survivorship, second-cancers.
Shares Thyroid cancer after neck radiotherapy, and whether to look for it, Skin cancer after cancer treatment, Bowel cancer after abdominal and pelvic radiotherapy, Lung cancer after chest radiotherapy and after alkylating chemotherapy and the tags rejuvenation, survivorship, second-cancers.
Shares The UK very high risk breast screening protocol after chest radiotherapy, Screening survivors: where the UK, American and European answers differ, Hodgkin lymphoma, Breast cancer (all types) and the tags rejuvenation, survivorship, screening, second-cancers.
Shares Recovery and rejuvenation roadmap: cure is not enough → survivorship gets a name → the cohorts that measured the cost → exercise proven as treatment → biological ageing measured and sold → repair, if anyone funds it and the tags rejuvenation, survivorship, open-problem, second-cancers.
Shares Recovery and rejuvenation roadmap: cure is not enough → survivorship gets a name → the cohorts that measured the cost → exercise proven as treatment → biological ageing measured and sold → repair, if anyone funds it and the tags rejuvenation, survivorship, open-problem, second-cancers.
Shares Skin cancer after cancer treatment, Screening survivors: where the UK, American and European answers differ, Breast cancer (all types) and the tags rejuvenation, survivorship, second-cancers.
Shares Lung cancer after chest radiotherapy and after alkylating chemotherapy, Screening survivors: where the UK, American and European answers differ, Hodgkin lymphoma and the tags rejuvenation, survivorship, second-cancers.
Shares Bladder cancer after cyclophosphamide, Bowel cancer after abdominal and pelvic radiotherapy, Hodgkin lymphoma, Breast cancer (all types) and the tags rejuvenation, survivorship, second-cancers.