While overall cancer rates in Canada continue to decline, reflecting decades of progress in screening and treatment, younger survivors face troubling gaps in their follow-up care. In the research article “Projected estimates of cancer in Canada in 2026” overall cancer incidence and mortality rates continue to decline when adjusted for population size, reflecting advances in screening, early detection, and treatment. But for adolescents and young adults, surviving cancer may mark the start of a more complex and less coordinated phase of care.

Dr. Darren Brenner, a molecular cancer epidemiologist at the University of Calgary, reports that more than 250,000 Canadians are expected to be diagnosed with cancer in 2026, with rates per 100,000 continuing to fall. Mortality has declined for several major cancers, though increases in pancreatic and uterine cancers highlight uneven progress. Brenner notes that a growing number of survivors are now living with elevated risk of second primary cancers and will require long-term follow-up.

Dr. Miranda Fidler-Benaoudia, a cancer epidemiologist at Cancer Care Alberta and co-author of the article, article “Subsequent primary neoplasm risk among survivors of cancer in adolescence and young adulthood: a population-based study from Alberta, Canada,” examines what happens after treatment for patients diagnosed between ages 15 and 39. Her study finds these survivors are twice as likely to develop a second primary cancer as their peers, often at younger ages than current screening programmes anticipate. Despite this, survivorship care is inconsistent. Patients treated in paediatric settings often receive lifelong, specialized follow-up, while those treated in adult systems may be discharged within a few years to primary care without standardized guidance or documentation. Many lack access to a family physician, and clinicians may not be equipped to manage the long-term risks associated with early cancer treatment.

For clinicians, these findings raise questions about how to manage a growing population of younger cancer survivors who face elevated risks over decades. Earlier onset of second cancers and the absence of clear follow-up pathways suggest current screening frameworks and transition practices may not be sufficient for this group.

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