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Cardiometabolic Risk in Childhood Cancer Survivors: A Report from the Children's Oncology Group
- Source :
- Cancer Epidemiology, Biomarkers & Prevention. 31:536-542
- Publication Year :
- 2022
- Publisher :
- American Association for Cancer Research (AACR), 2022.
-
Abstract
- Background: Childhood cancer survivors are at risk for cardiovascular disease. We assessed the burden of potentially modifiable cardiometabolic risk factors (CRF) among survivors compared with population-matched controls. Methods: Survivors previously enrolled on Pediatric Oncology Group protocols 9404, 9425, 9426, 9754, and Dana-Farber Cancer Institute 95-01 from 1996 to 2001 with acute lymphoblastic leukemia/lymphoma, Hodgkin lymphoma, or osteosarcoma were prospectively assessed for the prevalence of CRFs and compared with an age, sex, and race/ethnicity-matched 2013 National Health and Nutrition Examination Survey (NHANES) population. We estimated future predicted cardiovascular risk based on general population (e.g., Framingham) and Childhood Cancer Survivor Study (CCSS) models. Results: Compared with NHANES (n = 584), survivors [n = 164; 44.5% female, median age 28 years (range, 16–38 years); median 17.4 years (range, 13–22 years) since cancer diagnosis; median doxorubicin dose 300 mg/m2; 30.5% chest radiation] had similar rates of obesity, diabetes, and dyslipidemia, but more prehypertension/hypertension (38.4% vs. 30.1%, P = 0.044). Survivors had fewer metabolic syndrome features compared with NHANES (≥2 features: 26.7% vs. 55.9%; P < 0.001). Survivors were more physically active and smoked tobacco less (both P < 0.0001). Therefore, general population cardiovascular risk scores were lower for survivors versus NHANES. However, with CCSS models, 30.5% of survivors were at moderate risk of ischemic heart disease, and >95% at moderate/high risk for heart failure, with a 9% to 12% predicted incidence of these conditions by age 50 years. Conclusions: Childhood cancer survivors exhibited similar or better cardiometabolic and lifestyle profiles compared with NHANES, but nonetheless are at risk for future clinically significant cardiovascular disease. Impact: Further strategies supporting optimal CRF control are warranted in survivors. See related commentary by Mulrooney, p. 515
- Subjects :
- Adult
Male
Pediatrics
medicine.medical_specialty
Epidemiology
Population
Childhood Cancer Survivor Study
Disease
Cancer Survivors
Risk Factors
medicine
Humans
Child
education
education.field_of_study
Framingham Risk Score
business.industry
Incidence (epidemiology)
Cancer
Middle Aged
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Nutrition Surveys
medicine.disease
Oncology
Cardiovascular Diseases
Female
Metabolic syndrome
business
Dyslipidemia
Subjects
Details
- ISSN :
- 15387755 and 10559965
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Cancer Epidemiology, Biomarkers & Prevention
- Accession number :
- edsair.doi.dedup.....32f9233e426b18aae299eecf711dc5e0
- Full Text :
- https://doi.org/10.1158/1055-9965.epi-21-0360