Recommended screening (USPSTF) (32) and surveillance (COG) (23) for survivors at average or high risk of developing a second malignant neoplasm

Screening in survivors at AVERAGE risk of a second malignant neoplasm
	Breast	Cervix	Colorectal	Skin
USPSTF recommended screening for the general (average risk) population	Mammogram every 1 to 2 years for women aged 40 years or older	Papanicolaou smear every 3 years commencing at age 21 years*	**	Not applicable

Surveillance in survivors at HIGH risk of a second malignant neoplasm
	Breast	Cervix	Colorectal	Skin
Definition (COG) of high risk group	Female, ≥20 Gy radiation therapy to the chest	Not applicable	≥30 Gy radiation therapy to the abdomen, pelvis or spine	Any radiation therapy
COG recommended surveillance for survivors at high risk	Annual mammogram beginning 8 years after radiation or age 25 years, whichever occurs last***	Not applicable	Colonoscopy every 5 years beginning at age 35 years	Annual dermatologic exam of irradiated areas

^*Guideline recommends Papanicolaou smear screening to start at time of first sexual intercourse or age 21 years, whichever is earlier (http://www.ahrq.gov/clinic/3rduspstf/cervcan/cervcanrr.htm). Since time of first intercourse was not captured by the study questionnaire, we used age 21 years as the expected time of the commencement of screening.

^**Since few survivors in the cohort have reached the age at which colorectal cancer screening in the general population is recommended, this outcome is not presented in this analysis

^***Breast MRI was identified as an adjunct to mammography in a revised version of the COG surveillance guidelines published in 2008 after the completion of the study surveys.

MRI is not assessed in this analysis.