The purpose of this literature synthesis was to (a) identify second malignant neoplasms found in childhood cancer survivors and (b) make recommendations for the advanced practice nurse's role in the primary care setting regarding health promotion activities and surveillance strategies for survivors across the life span. The database search produced 73 research articles published in English between 1990 and 2000 that were significant to the purpose of the study. The results identified genetic or familial factors, radiation therapy, and chemotherapy as risk factors for later developing a second malignant neoplasm. Each theme was analyzed, and guidelines were developed for primary care advanced practice nurses which integrated health promotion and surveillance activities for this patient population.
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