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7. Genome-Wide Association Study of Pregnancy in Childhood Cancer Survivors: A Report from the Childhood Cancer Survivor Study.

Author

Rotz, Seth J, Worley, Sarah, Hu, Bo, Bazeley, Peter, Baedke, Jessica L, Hudson, Melissa M, Kuo, Dennis J, Oeffinger, Kevin C, Robison, Leslie L, Sahoo, Debashis, Wang, Fan, Yasui, Yutaka, Armstrong, Gregory T, and Bhatia, Smita

Subjects
Contraception/Reproduction, Genetics, Human Genome, Pediatric, Pediatric Cancer, Prevention, Cancer, Infertility, 2.1 Biological and endogenous factors, Aetiology, Reproductive health and childbirth, Cancer Survivors, Child, Cohort Studies, Female, Genome-Wide Association Study, Humans, Neoplasms, Pregnancy, Quality of Life, Medical and Health Sciences, Epidemiology
Abstract

BackgroundGonadotoxic treatment-related infertility has a significant impact on quality of life in childhood cancer survivors. Genome-wide association analyses to delineate the risk of infertility in childhood cancer survivors have not been previously reported.MethodsLeveraging genotype data from a large survivor cohort, the Childhood Cancer Survivor Study (CCSS), we investigated the role of SNPs on future pregnancy or siring a pregnancy in survivors without pelvic, testicular, or brain radiation who had ever been married. We calculated sex-stratified hazard ratios, using Cox proportional hazards modeling, adjusting for birth cohort (before 1965 vs. 1965 or later) and doses of relevant chemotherapies; replication was attempted in the independent St. Jude Lifetime Cohort study (SJLIFE).ResultsIn the CCSS cohort, nine SNPs were found to be suggestive (P < 10-7) or statistically significantly (P < 5 × 10-8) associated with pregnancy, however, none of the SNPs were replicated in SJLIFE. Cohorts differed based on the overall pregnancy rate, frequency of sterilizing procedures, and birth cohort.ConclusionsWe were not able to replicate our findings of SNPs associated with pregnancy in childhood cancer survivors.ImpactFuture attempts at replication should be considered in cohorts treated in a comparable era. In addition, understanding the role of genetics in fertility in childhood cancer survivors may be better approached using more advanced sequencing techniques.

Published
2022

8. Subsequent female breast cancer risk associated with anthracycline chemotherapy for childhood cancer

Author

Wang, Yuehan, Ronckers, Cécile M., van Leeuwen, Flora E., Moskowitz, Chaya S., Leisenring, Wendy, Armstrong, Gregory T., de Vathaire, Florent, Hudson, Melissa M., Kuehni, Claudia E., Arnold, Michael A., Demoor-Goldschmidt, Charlotte, Green, Daniel M., Henderson, Tara O., Howell, Rebecca M., Ehrhardt, Matthew J., Neglia, Joseph P., Oeffinger, Kevin C., van der Pal, Helena J. H., Robison, Leslie L., Schaapveld, Michael, Turcotte, Lucie M., Waespe, Nicolas, Kremer, Leontien C. M., and Teepen, Jop C.

Published
2023
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9. The burden of cardiovascular disease and risk for subsequent major adverse cardiovascular events in survivors of childhood cancer: a prospective, longitudinal analysis from the St Jude Lifetime Cohort Study

Author

Hammoud, Rawan A, Liu, Qi, Dixon, Stephanie B, Onerup, Aron, Mulrooney, Daniel A, Huang, I-Chan, Jefferies, John L, Rhea, Isaac B, Ness, Kirsten K, Ehrhardt, Matthew J, Hudson, Melissa M, Ky, Bonnie, Bhakta, Nickhill, Sapkota, Yadav, Yasui, Yutaka, and Armstrong, Gregory T

Published
2024
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13. Pediatric Normal Tissue Effects in the Clinic (PENTEC): An International Collaboration to Assess Normal Tissue Radiation Dose-Volume-Response Relationships for Children With Cancer

Author

Constine, Louis S., Olch, Arthur J., Jackson, Andrew, Hua, Chia-Ho, Ronckers, Cecile M., Milano, Michael T., Marcus, Karen J., Yorke, Ellen, Hodgson, David C., Howell, Rebecca M., Hudson, Melissa M., Williams, Jacqueline P., Marples, Brian, C.M. Kremer, Leontien, Marks, Lawrence B., and Bentzen, Søren M.

Published
2024
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14. Identification of novel hypermethylated or hypomethylated CpG sites and genes associated with anthracycline-induced cardiomyopathy

Author

Singh, Purnima, Zhou, Liting, Shah, Disheet A., Cejas, Romina B., Crossman, David K., Jouni, Mariam, Magdy, Tarek, Wang, Xuexia, Sharafeldin, Noha, Hageman, Lindsey, McKenna, Donald E., Horvath, Steve, Armenian, Saro H., Balis, Frank M., Hawkins, Douglas S., Keller, Frank G., Hudson, Melissa M., Neglia, Joseph P., Ritchey, A. Kim, Ginsberg, Jill P., Landier, Wendy, Burridge, Paul W., and Bhatia, Smita

Published
2023
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17. Distinct DNA methylation signatures associated with blood lipids as exposures or outcomes among survivors of childhood cancer: a report from the St. Jude lifetime cohort

Author

Dong, Qian, Chen, Cheng, Song, Nan, Qin, Na, Plonski, Noel-Marie, Finch, Emily R., Shelton, Kyla, Easton, John, Mulder, Heather, Plyer, Emily, Neale, Geoffrey, Walker, Emily, Li, Qian, Huang, I-Chan, Zhang, Jinghui, Wang, Hui, Hudson, Melissa M., Robison, Leslie L., Ness, Kirsten K., and Wang, Zhaoming

Published
2023
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18. Breast Cancer Screening Among Childhood Cancer Survivors Treated Without Chest Radiation: Clinical Benefits and Cost-Effectiveness.

Author

Yeh, Jennifer M, Lowry, Kathryn P, Schechter, Clyde B, Diller, Lisa R, O'Brien, Grace, Alagoz, Oguzhan, Armstrong, Gregory T, Hampton, John M, Hudson, Melissa M, Leisenring, Wendy, Liu, Qi, Mandelblatt, Jeanne S, Miglioretti, Diana L, Moskowitz, Chaya S, Nathan, Paul C, Neglia, Joseph P, Oeffinger, Kevin C, Trentham-Dietz, Amy, and Stout, Natasha K

Subjects
Clinical Research, Clinical Trials and Supportive Activities, Pediatric Research Initiative, Comparative Effectiveness Research, Health Services, Rare Diseases, Pediatric Cancer, Biomedical Imaging, Pediatric, Cancer, Prevention, Cost Effectiveness Research, Breast Cancer, Detection, screening and diagnosis, 4.2 Evaluation of markers and technologies, Good Health and Well Being, Adult, Breast Neoplasms, Cancer Survivors, Child, Cost-Benefit Analysis, Early Detection of Cancer, Female, Humans, Mammography, Mass Screening, Quality-Adjusted Life Years, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

BackgroundEarly initiation of breast cancer screening is recommended for high-risk women, including survivors of childhood cancer treated with chest radiation. Recent studies suggest that female survivors of childhood leukemia or sarcoma treated without chest radiation are also at elevated early onset breast cancer risk. However, the potential clinical benefits and cost-effectiveness of early breast cancer screening among these women are uncertain.MethodsUsing data from the Childhood Cancer Survivor Study, we adapted 2 Cancer Intervention and Surveillance Modeling Network simulation models to reflect the elevated risks of breast cancer and competing mortality among leukemia and sarcoma survivors. Costs and utility weights were based on published studies and databases. Outcomes included breast cancer deaths averted, false-positive screening results, benign biopsies, and incremental cost-effectiveness ratios.ResultsIn the absence of screening, the lifetime risk of dying from breast cancer among survivors was 6.8% to 7.0% across models. Early initiation of annual mammography with breast magnetic resonance imaging screening between ages 25 and 40 years would avert 52.6% to 64.3% of breast cancer deaths. When costs and quality-of-life impacts were considered, screening starting at age 40 years was the only strategy with an incremental cost-effectiveness ratio below the $100 000 per quality-adjusted life-year (QALY) gained cost-effectiveness threshold ($27 680 to $44 380 per QALY gained across models).ConclusionsAmong survivors of childhood leukemia or sarcoma, early initiation of breast cancer screening at age 40 years may reduce breast cancer deaths by half and is cost-effective. These findings could help inform screening guidelines for survivors treated without chest radiation.

Published
2022

19. A joint international consensus statement for measuring quality of survival for patients with childhood cancer

Author

van Kalsbeek, Rebecca J., Hudson, Melissa M., Mulder, Renée L., Ehrhardt, Matthew, Green, Daniel M., Mulrooney, Daniel A., Hakkert, Jessica, den Hartogh, Jaap, Nijenhuis, Anouk, van Santen, Hanneke M., Schouten-van Meeteren, Antoinette Y. N., van Tinteren, Harm, Verbruggen, Lisanne C., Conklin, Heather M., Jacola, Lisa M., Webster, Rachel Tillery, Partanen, Marita, Kollen, Wouter J. W., Grootenhuis, Martha A., Pieters, Rob, and Kremer, Leontien C. M.

Published
2023
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20. Recommendations for surveillance of pulmonary dysfunction among childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group

Author

Otth, Maria, Kasteler, Rahel, Mulder, Renée L., Agrusa, Jennifer, Armenian, Saro H., Barnea, Dana, Bergeron, Anne, Bhatt, Neel S., Bourke, Stephen J., Constine, Louis S., Goutaki, Myrofora, Green, Daniel M., Hennewig, Ulrike, Houdouin, Veronique, Hudson, Melissa M., Kremer, Leontien, Latzin, Philipp, Ng, Antony, Oeffinger, Kevin C., Schindera, Christina, Skinner, Roderick, Sommer, Grit, Srinivasan, Saumini, Stokes, Dennis C., Versluys, Birgitta, Waespe, Nicolas, Weiner, Daniel J., Dietz, Andrew C., and Kuehni, Claudia E.

Published
2024
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24. Interindividual variation in ovarian reserve after gonadotoxic treatment in female childhood cancer survivors – a genome-wide association study: results from PanCareLIFE

Author

van der Perk, M.E. Madeleine, Broer, Linda, Yasui, Yutaka, Laven, Joop S.E., Robison, Leslie L., Tissing, Wim J.E., Versluys, Birgitta, Bresters, Dorine, Kaspers, Gertjan J.L., Lambalk, Cornelis B., Overbeek, Annelies, Loonen, Jacqueline J., Beerendonk, Catharina C.M., Byrne, Julianne, Berger, Claire, Clemens, Eva, van Dulmen-den Broeder, Eline, Dirksen, Uta, van der Pal, Helena J., de Vries, Andrica C.H., Winther, Jeanette Falck, Ranft, Andreas, Fosså, Sophie D., Grabow, Desiree, Muraca, Monica, Kaiser, Melanie, Kepák, Tomáš, Kruseova, Jarmila, Modan-Moses, Dalit, Spix, Claudia, Zolk, Oliver, Kaatsch, Peter, Kremer, Leontien C.M., Brooke, Russell J., Wang, Fan, Baedke, Jessica L., Uitterlinden, André G., Bos, Annelies M.E., van Leeuwen, Flora E., Ness, Kirsten K., Hudson, Melissa M., van der Kooi, Anne-Lotte L.F., and van den Heuvel-Eibrink, Marry M.

Published
2024
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25. Author Correction: A joint international consensus statement for measuring quality of survival for patients with childhood cancer

Author

van Kalsbeek, Rebecca J., Hudson, Melissa M., Mulder, Renée L., Ehrhardt, Matthew, Green, Daniel M., Mulrooney, Daniel A., Hakkert, Jessica, den Hartogh, Jaap, Nijenhuis, Anouk, van Santen, Hanneke M., Schouten-van Meeteren, Antoinette Y. N., van Tinteren, Harm, Verbruggen, Lisanne C., Conklin, Heather M., Jacola, Lisa M., Webster, Rachel Tillery, Partanen, Marita, Kollen, Wouter J. W., Grootenhuis, Martha A., Pieters, Rob, and Kremer, Leontien C. M.

Published
2024
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26. Long-term Follow-up Care for Childhood, Adolescent, and Young Adult Cancer Survivors

Author

Hudson, Melissa M, Bhatia, Smita, Casillas, Jacqueline, Landier, Wendy, Rogers, Zora R, Allen, Carl, Harper, James, Hord, Jeffrey, Jain, Juhi, Warwick, Anne, Wetmore, Cynthia, Yates, Amber, Lipton, Jeffrey, Wilson, Hope, Leavey, Patrick, Billett, Amy, DiPaola, Jorge, Graham, Doug, Hastings, Caroline, Matthews, Dana, Pace, Betty, Stork, Linda, Velez, Maria C, and Wechsler, Dan

Subjects
Health Services and Systems, Biomedical and Clinical Sciences, Nursing, Health Sciences, Clinical Research, Pediatric, Pediatric Cancer, Cancer, Prevention, Behavioral and Social Science, Pediatric Research Initiative, Good Health and Well Being, Adolescent, Adult, Aftercare, Cancer Survivors, Child, Delivery of Health Care, Follow-Up Studies, Humans, Male, Neoplasms, Survivors, Young Adult, SECTION ON HEMATOLOGY/ONCOLOGY, CHILDREN’S ONCOLOGY GROUP, AMERICAN SOCIETY OF PEDIATRIC HEMATOLOGY/ONCOLOGY, Medical and Health Sciences, Psychology and Cognitive Sciences, Pediatrics, Biomedical and clinical sciences, Health sciences, Psychology
Abstract

Progress in therapy has made survival into adulthood a reality for most children, adolescents, and young adults with a cancer diagnosis today. Notably, this growing population remains vulnerable to a variety of long-term therapy-related sequelae. Systematic ongoing follow-up of these patients is, therefore, important to provide for early detection of and intervention for potentially serious late-onset complications. In addition, health counseling and promotion of healthy lifestyles are important aspects of long-term follow-up care to promote risk reduction for physical and emotional health problems that commonly present during adulthood. Both general and subspecialty health care providers are playing an increasingly important role in the ongoing care of childhood cancer survivors, beyond the routine preventive care, health supervision, and anticipatory guidance provided to all patients. This report is based on the guidelines that have been developed by the Children's Oncology Group to facilitate comprehensive long-term follow-up of childhood, adolescent, and young adult cancer survivors (www.survivorshipguidelines.org).

Published
2021

28. Gene-Level Analysis of Anthracycline-Induced Cardiomyopathy in Cancer Survivors: A Report From COG-ALTE03N1, BMTSS, and CCSS

Author

Sharafeldin, Noha, Zhou, Liting, Singh, Purnima, Crossman, David K., Wang, Xuexia, Hageman, Lindsey, Landier, Wendy, Blanco, Javier G., Burridge, Paul W., Sapkota, Yadav, Yasui, Yutaka, Armstrong, Gregory T., Robison, Leslie L., Hudson, Melissa M., Oeffinger, Kevin, Chow, Eric J., Armenian, Saro H., Weisdorf, Daniel J., and Bhatia, Smita

Published
2023
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29. Development and validation of age-specific risk prediction models for primary ovarian insufficiency in long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study and St Jude Lifetime Cohort

Author

Im, Cindy, Lu, Zhe, Mostoufi-Moab, Sogol, Delaney, Angela, Yu, Lin, Baedke, Jessica L, Han, Yutong, Sapkota, Yadav, Yasui, Yutaka, Chow, Eric J, Howell, Rebecca M, Bhatia, Smita, Hudson, Melissa M, Ness, Kirsten K, Armstrong, Gregory T, Nathan, Paul C, and Yuan, Yan

Published
2023
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32. Cancer germline predisposing variants and late mortality from subsequent malignant neoplasms among long-term childhood cancer survivors: a report from the St Jude Lifetime Cohort and the Childhood Cancer Survivor Study

Author

Chen, Cheng, Qin, Na, Wang, Mingjuan, Dong, Qian, Tithi, Saima Sultana, Hui, Yawei, Chen, Wenan, Wu, Gang, Kennetz, Dennis, Edmonson, Michael N, Rusch, Michael C, Thrasher, Andrew, Easton, John, Mulder, Heather L, Song, Nan, Plonski, Noel-Marie, Shelton, Kyla, Im, Cindy, Ehrhardt, Matthew J, Nichols, Kim E, Leisenring, Wendy M, Stratton, Kayla L, Howell, Rebecca, Yasui, Yutaka, Bhatia, Smita, Armstrong, Gregory T, Ness, Kirsten K, Hudson, Melissa M, Zhang, Jinghui, Wang, Hui, Srivastava, Deo Kumar, Robison, Leslie L, and Wang, Zhaoming

Published
2023
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33. Childhood cancer survivorship care during the COVID-19 pandemic: an international report of practice implications and provider concerns

Author

van den Oever, Selina R., Pluijm, Saskia M. F., Skinner, Rod, Glaser, Adam, Mulder, Renée L., Armenian, Saro, Bardi, Edit, Berger, Claire, Ehrhardt, Matthew J., Gilleland Marchak, Jordan, Haeusler, Gabrielle M., Hartogh, Jaap den, Hjorth, Lars, Kepak, Tomas, Kriviene, Izolda, Langer, Thorsten, Maeda, Miho, Márquez-Vega, Catalina, Michel, Gisela, Muraca, Monica, Najib, Mohamed, Nathan, Paul C., Panasiuk, Anna, Prasad, Maya, Roganovic, Jelena, Uyttebroeck, Anne, Winther, Jeanette F., Zadravec Zaletel, Lorna, van Dalen, Elvira C., van der Pal, Helena J. H., Hudson, Melissa M., and Kremer, Leontien C. M.

Published
2022
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37. Specific causes of excess late mortality and association with modifiable risk factors among survivors of childhood cancer: a report from the Childhood Cancer Survivor Study cohort

Author

Dixon, Stephanie B, Liu, Qi, Chow, Eric J, Oeffinger, Kevin C, Nathan, Paul C, Howell, Rebecca M, Leisenring, Wendy M, Ehrhardt, Matthew J, Ness, Kirsten K, Krull, Kevin R, Mertens, Ann C, Hudson, Melissa M, Robison, Leslie L, Yasui, Yutaka, and Armstrong, Gregory T

Published
2023
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44. Recommendations for the surveillance of mental health problems in childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group

Author

Marchak, Jordan Gilleland, Christen, Salome, Mulder, Renée L, Baust, Katja, Blom, Johanna M C, Brinkman, Tara M, Elens, Iris, Harju, Erika, Kadan-Lottick, Nina S, Khor, Joel W T, Lemiere, Jurgen, Recklitis, Christopher J, Wakefield, Claire E, Wiener, Lori, Constine, Louis S, Hudson, Melissa M, Kremer, Leontien C M, Skinner, Roderick, Vetsch, Janine, Lee, Jennifer L, and Michel, Gisela

Published
2022
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47. Genome-wide association study of posttraumatic stress disorder among childhood cancer survivors: results from the Childhood Cancer Survivor Study and the St. Jude Lifetime Cohort

Author

Lu, Donghao, Sapkota, Yadav, Valdimarsdóttir, Unnur A., Koenen, Karestan C., Li, Nan, Leisenring, Wendy M., Gibson, Todd, Wilson, Carmen L., Robison, Leslie L., Hudson, Melissa M., Armstrong, Gregory T., Krull, Kevin R., Yasui, Yutaka, Bhatia, Smita, and Recklitis, Christopher J.

Published
2022
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48. Estimating transition intensity rate on interval-censored data using semi-parametric with EM algorithm approach.

Author

Qian, Chen, Srivastava, Deo Kumar, Pan, Jianmin, Hudson, Melissa M., and Rai, Shesh N.

Subjects
EXPECTATION-maximization algorithms, CENSORING (Statistics), PARAMETRIC modeling, CHILDHOOD cancer, CARDIOTOXICITY, PARAMETER estimation
Abstract

Phase IV clinical trials are designed to monitor long-term side effects of medical treatment. For instance, childhood cancer survivors treated with chest radiation and/or anthracycline are often at risk of developing cardiotoxicity during their adulthood. Often the primary focus of a study could be on estimating the cumulative incidence of a particular outcome of interest such as cardiotoxicity. However, it is challenging to evaluate patients continuously and usually, this information is collected through cross-sectional surveys by following patients longitudinally. This leads to interval-censored data since the exact time of the onset of the toxicity is unknown. Rai et al. computed the transition intensity rate using a parametric model and estimated parameters using maximum likelihood approach in an illness-death model. However, such approach may not be suitable if the underlying parametric assumptions do not hold. This manuscript proposes a semi-parametric model, with a logit relationship for the treatment intensities in two groups, to estimate the transition intensity rates within the context of an illness-death model. The estimation of the parameters is done using an EM algorithm with profile likelihood. Results from the simulation studies suggest that the proposed approach is easy to implement and yields comparable results to the parametric model. [ABSTRACT FROM AUTHOR]

Published
2024
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49. Post‐diagnosis dietary factors, supplement use and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis.

Author

Chan, Doris S. M., Cariolou, Margarita, Markozannes, Georgios, Balducci, Katia, Vieira, Rita, Kiss, Sonia, Becerra‐Tomás, Nerea, Aune, Dagfinn, Greenwood, Darren C., González‐Gil, Esther M., Copson, Ellen, Renehan, Andrew G., Bours, Martijn, Demark‐Wahnefried, Wendy, Hudson, Melissa M., May, Anne M., Odedina, Folakemi T., Skinner, Roderick, Steindorf, Karen, and Tjønneland, Anne

Subjects
COLORECTAL cancer, CANCER prognosis, DIETARY patterns, PEANUT allergy, CANCER of unknown primary origin, OMEGA-3 fatty acids, UNSATURATED fatty acids
Abstract

The role of diet in colorectal cancer prognosis is not well understood and specific lifestyle recommendations are lacking. We searched for randomised controlled trials (RCTs) and longitudinal observational studies on post‐diagnosis dietary factors, supplement use and colorectal cancer survival outcomes in PubMed and Embase from inception until 28th February 2022. Random‐effects dose–response meta‐analyses were conducted when at least three studies had sufficient information. The evidence was interpreted and graded by the CUP Global independent Expert Committee on Cancer Survivorship and Expert Panel. Five RCTs and 35 observational studies were included (30,242 cases, over 8700 all‐cause and 2100 colorectal cancer deaths, 3700 progression, recurrence, or disease‐free events). Meta‐analyses, including 3–10 observational studies each, were conducted for: whole grains, nuts/peanuts, red and processed meat, dairy products, sugary drinks, artificially sweetened beverages, coffee, alcohol, dietary glycaemic load/index, insulin load/index, marine omega‐3 polyunsaturated fatty acids, supplemental calcium, circulating 25‐hydroxyvitamin D (25[OH]D) and all‐cause mortality; for alcohol, supplemental calcium, circulating 25(OH)D and colorectal cancer‐specific mortality; and for circulating 25(OH)D and recurrence/disease‐free survival. The overall evidence was graded as 'limited'. The inverse associations between healthy dietary and/or lifestyle patterns (including diets that comprised plant‐based foods), whole grains, total, caffeinated, or decaffeinated coffee and all‐cause mortality and the positive associations between unhealthy dietary patterns, sugary drinks and all‐cause mortality provided 'limited—suggestive' evidence. All other exposure‐outcome associations provided 'limited—no conclusion' evidence. Additional, well‐conducted cohort studies and carefully designed RCTs are needed to develop specific lifestyle recommendations for colorectal cancer survivors. [ABSTRACT FROM AUTHOR]

Published
2024
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50. Post‐diagnosis adiposity and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis.

Author

Becerra‐Tomás, Nerea, Markozannes, Georgios, Cariolou, Margarita, Balducci, Katia, Vieira, Rita, Kiss, Sonia, Aune, Dagfinn, Greenwood, Darren C., Dossus, Laure, Copson, Ellen, Renehan, Andrew G., Bours, Martijn, Demark‐Wahnefried, Wendy, Hudson, Melissa M., May, Anne M., Odedina, Folakemi T., Skinner, Roderick, Steindorf, Karen, Tjønneland, Anne, and Velikova, Galina

Subjects
COLORECTAL cancer, CANCER prognosis, CANCER of unknown primary origin, OBESITY, WAIST-hip ratio, CANCER relapse, CLINICAL trials
Abstract

The adiposity influence on colorectal cancer prognosis remains poorly characterised. We performed a systematic review and meta‐analysis on post‐diagnosis adiposity measures (body mass index [BMI], waist circumference, waist‐to‐hip ratio, weight) or their changes and colorectal cancer outcomes. PubMed and Embase were searched through 28 February 2022. Random‐effects meta‐analyses were conducted when at least three studies had sufficient information. The quality of evidence was interpreted and graded by the Global Cancer Update Programme (CUP Global) independent Expert Committee on Cancer Survivorship and Expert Panel. We reviewed 124 observational studies (85 publications). Meta‐analyses were possible for BMI and all‐cause mortality, colorectal cancer‐specific mortality, and cancer recurrence/disease‐free survival. Non‐linear meta‐analysis indicated a reverse J‐shaped association between BMI and colorectal cancer outcomes (nadir at BMI 28 kg/m2). The highest risk, relative to the nadir, was observed at both ends of the BMI distribution (18 and 38 kg/m2), namely 60% and 23% higher risk for all‐cause mortality; 95% and 26% for colorectal cancer‐specific mortality; and 37% and 24% for cancer recurrence/disease‐free survival, respectively. The higher risk with low BMI was attenuated in secondary analyses of RCTs (compared to cohort studies), among studies with longer follow‐up, and in women suggesting potential methodological limitations and/or altered physiological state. Descriptively synthesised studies on other adiposity‐outcome associations of interest were limited in number and methodological quality. All the associations were graded as limited (likelihood of causality: no conclusion) due to potential methodological limitations (reverse causation, confounding, selection bias). Additional well‐designed observational studies and interventional trials are needed to provide further clarification. [ABSTRACT FROM AUTHOR]

Published
2024
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