Any prior cancer history (any site, treatment completed, currently no evidence of active...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-UNIVERSAL-PRIOR-CANCER-SECONDARY-RISK`
Type	Red flag
Status	reviewed 2026-05-18 \| pending_clinical_signoff
Diseases	None declared
Sources	`SRC-COG` `SRC-NCCN-BREAST-2025` `SRC-NCCN-COLON-2025`

Red Flag Origin

Definition	Any prior cancer history (any site, treatment completed, currently no evidence of active recurrent disease — survivor cohort). Secondary-malignancy risk in cancer survivors is well-characterized in two cohorts: (1) Childhood Cancer Survivor Study (CCSS) + Children's Oncology Group Long-Term Follow-Up (COG-LTFU) Guidelines v5.0 — survivors of pediatric cancers face cumulative incidence of second neoplasm reaching 20-25% at 30 years post- diagnosis, dominated by therapy-related solid tumors (breast in chest-RT survivors, CNS in cranial-RT, thyroid in neck-RT, sarcoma and gastrointestinal in TBI / alkylator survivors) and therapy-related myeloid neoplasms; (2) NCCN Survivorship 2025 guidelines for adult-cancer survivors — second-primary-cancer risk is elevated 1.5-3× general-population baseline depending on treatment exposures (anthracycline + chest-RT for Hodgkin and breast survivors carr...
Clinical direction	investigate
Category	other

Trigger Logic

{
  "any_of": [
    {
      "finding": "prior_cancer_history_completed",
      "value": true
    }
  ],
  "type": "composite_score"
}

Notes

Pre-triage universal RedFlag — any prior-cancer survivor with treatment completed. Authoring intent: route to structured survivorship surveillance (NCCN Survivorship 2025 + COG-LTFU v5.0 treatment-summary-driven cadence). risk_category=iatrogenic reflects that the elevated secondary-malignancy risk is therapy-related rather than tumor-biology-intrinsic. With relevant_diseases=["*"], engine does NOT attach Indication tracks via prevention path (plan.py:297 excludes "*") — universal Indications anchored to DIS-CRC (heterogeneous survivor surveillance defaults to CRC + breast cadence individualization) are documentation / sidecar candidates pending future engine extension. STUB pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode.

Used By

Indications

IND-UNIVERSAL-PRIOR-CANCER-PREVENTION-ROUTINE-FOLLOWUP - IND-UNIVERSAL-PRIOR-CANCER-PREVENTION-ROUTINE-FOLLOWUP
IND-UNIVERSAL-PRIOR-CANCER-PREVENTION-SURVIVORSHIP-PROGRAM - IND-UNIVERSAL-PRIOR-CANCER-PREVENTION-SURVIVORSHIP-PROGRAM