Screening for CRC in Childhood Cancer Survivors Treated With Abdominopelvic Radiation

Colorectal

Douglas K. Rex, MD, MASGE reviewing Yeh JM, et al. J Clin Oncol 2025 Dec 17.

According to a recent modeling study, the cumulative risk of colorectal cancer (CRC) in 45-year-old survivors of childhood cancer treated with abdominopelvic radiation was 0.6%. Screening prevented 47 to 73 CRC cases and 23 to 29 CRC deaths per 1000 survivors.

Modeling indicated that optimal screening strategies are colonoscopy every 10 years beginning at age 30, multitarget stool DNA testing every 3 years beginning at age 30, or fecal immunochemical testing every 3 years beginning at age 25 and annually starting at age 45.

Comment:

The Children’s Oncology Group already recommends initiating CRC screening at age 30 or at least 5 years after completion of abdominopelvic radiation therapy in childhood cancer survivors. This study is a reminder to offer CRC screening to these patients by age 30.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

Douglas K. Rex, MD, MASGE

Bio and Disclosures

Citation(s):

Yeh JM, Seguin CL, Stratton KL, et al. Benefits, harms, and burden of colorectal cancer screening among childhood cancer survivors previously treated with abdominopelvic radiation. J Clin Oncol 2025 Dec 17. (Epub ahead of print) (https://doi.org/10.1200/jco-25-00661)