Obesity in survivors of childhood cancer.
In a historical cohort of 820 childhood cancer survivors, overweight/obesity was more frequent than in the general population and was associated with weight status at cancer diagnosis, endocrine dysfunction, age at diagnosis, and a peak risk 3–5 years after diagnosis.
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In a historical cohort of 820 childhood cancer survivors, overweight/obesity was more frequent than in the general population and was associated with weight status at cancer diagnosis, endocrine dysfunction, age at diagnosis, and a peak risk 3–5 years after diagnosis.
Research significance
The study provides observational evidence for identifiable obesity-risk groups and a potentially important post-diagnosis surveillance window; it is reasonable to hypothesize that targeted weight-management and endocrine interventions could reduce later morbidity, but no intervention, treatment effect, or causal benefit was tested.
Source abstract
PURPOSE: Several studies reported previously increased risk for obesity in childhood cancer survivors (CCS). The objectives of this article were to evaluate the rate of overweight and obesity in CCS compared to the general population, to identify possible risk factors for obesity in these patients, and to assess changes in weight status over time. METHODS: A historical cohort including all patients (n=820) treated at a tertiary center over a twenty-year period, who were diagnosed with cancer at age <18 years, and had at least one year of follow-up after completion of anti-cancer treatment. RESULTS: Higher rates of overweight/obesity were observed in the CCS cohort compared to the general population. Weight status at the time of diagnosis (OR=1.69 95%CI 1.38-2.07, p<0.01), endocrine dysfunctions (OR=1.46, 95%CI 1.08-1.98, p=0.01), and age at diagnosis were identified as significant risk factors for overweight/obesity in CCS. Treatment with radiation alone had a close to significant effect (OR=1.8 95%. CI 0.91-3.53, p=0.09) on overweight/obesity. Rates of overweight/obesity peaked 3-5 years after diagnosis (OR=1.3, 95% CI 1.11-1.53, p<0.01) and declined thereafter. CONCLUSION: Better understanding of possible risk factors and characterization of high-risk groups of patients may assist in planning appropriate interventions that might decrease obesity and related morbidity in CCS.