Letter from Dr. Armstrong | Fall 2025

In this issue of LTFU Update, we share how your genes, past cancer treatment, and health habits can affect your cancer risk later in life. We also explain new cancer screening tools that researchers are studying.

We share what the Children’s Oncology Group (COG) recommends about early cancer screening. Your recommended screenings depend on your cancer treatment and family history. COG is a large network of doctors, nurses, and researchers who work together to improve care for childhood cancer patients and survivors. COG has created guidelines for survivors to help you stay healthy later in life. 

We talk to researcher Yadav Sapkota, PhD, of St. Jude Children’s Research Hospital. His team studied how certain risk factors had an impact on childhood cancer survivors having a second cancer. They incorporated a polygenic risk score into a tool that uses multiple risk factors to "predict" cancer risk in survivors. 

We also talk about multi-cancer detection (MCD) tests with Ruth Etzioni, PhD, of Fred Hutchinson Cancer Center. These are blood tests that may find cancer before symptoms appear. These tests are still under study, but they show promise for the future.

Finally, we hear from Emily Browne, DNP, RN, a childhood cancer survivor. She is director of the Transition Oncology Program at St. Jude. She explains why screening tests—like mammograms and colonoscopies—are so important. Here is a table that gives general screening guidelines for childhood cancer survivors:

Average risk survivors: When to start talking about cancer screening