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Enhanced screening for SM is recommended, but compliance is poor. We hypothesized that CCS with adult\u2010onset SM (colorectal cancer [CRC], melanoma, or breast cancer [BC]) would present with more advanced disease and have decreased overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Surveillance, Epidemiology, and End Results Program was queried for patients diagnosed with cancer at age less than or equal to 18 also diagnosed with adult\u2010onset CRC, melanoma, or BC. A cohort without a history of prior malignancy was likewise identified. Tumor features and clinical outcomes were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CCS with a SM (<jats:italic>n<\/jats:italic>\u2009=\u2009224) were compared with patients without a childhood cancer history (<jats:italic>n<\/jats:italic>\u2009=\u20091,392,670). CCS were diagnosed younger (BC\u2009=\u200937.6 vs. 61.3, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01, CRC\u2009=\u200935.0 vs. 67.1, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01, melanoma\u2009=\u200929.6 vs. 61.3 years old, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). CCS with BC were more likely to have Stage III or IV disease (25.2% vs. 16.5%, <jats:italic>p<\/jats:italic>\u2009=\u20090.01). Hormone\u2010receptor expression also differed; CCS were less likely to develop Luminal A\u2010type tumors (48.6% vs. 66.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.01). After age\u2010adjustment, CCS had worse OS (Hazard ratio: CRC\u2009=\u20092.449, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01, melanoma\u2009=\u20096.503, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01, BC\u2009=\u20093.383, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CCS were younger when diagnosed with a SM. After age\u2010adjustment, OS was diminished. Heightened surveillance may be necessary for CCS diagnosed with SM.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.26478","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T20:02:25Z","timestamp":1617220945000},"page":"16-24","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Childhood cancer survivors face markedly worse overall survival after diagnosis with breast cancer, melanoma, or colorectal cancer"],"prefix":"10.1002","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9845-6617","authenticated-orcid":false,"given":"Kevin T.","family":"Lynch","sequence":"first","affiliation":[{"name":"Department of Surgery University of Virginia Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Kane","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Virginia Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Fleming","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Virginia Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj P.","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences University of Virginia Cancer Center Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayna L.","family":"Showalter","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Virginia Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig L.","family":"Slingluff","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Virginia Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel E.","family":"Levin","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Virginia Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Traci L.","family":"Hedrick","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Virginia Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,31]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-015-0637-x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-14-1418"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1667\/RR1903.1"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.7764"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq238"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.747"},{"key":"e_1_2_9_8_1","unstructured":"COG C.New Malignancies Among Cancer Survivors \u2010 SEER Cancer Registries 1973\u20102000 \u2010 SEER Publications. 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