Obesity rate lower for childhood cancer survivors vs. general population
Click Here to Manage Email Alerts
Key takeaways:
- Survivors of most types of childhood cancer are less likely to develop obesity than the general population.
- Higher pituitary gland irradiation doses and etoposide therapy increase the risk for obesity.
Childhood cancer survivors in France are less likely to develop obesity compared with the country’s general population, according to a study published in Obesity.
“In this national study, we found that the prevalence of obesity is lower in French Childhood Cancer Survivor Study patients than in the general French population,” Florent de Vathaire, PhD, head of the radiation epidemiology and cancer survivorship team at INSERM U1018 in Villejuif, France, and colleagues wrote. “Pituitary irradiation 5 Gy and etoposide administration were associated with an increased risk of obesity in adulthood. Currently, treatment protocols limit the indications for brain irradiation, particularly for low-grade gliomas or medulloblastomas in young children.”
Researchers analyzed data from 3,199 participants in the French Childhood Cancer Survivor Study who were treated for any childhood cancer except leukemia before age 21 years at five centers in France and self-reported height and weight during a follow-up questionnaire. collected. Follow-up continued until Dec. 31, 2017. The obesity rate among childhood cancer survivors was compared with the expected rate from the France general population using sex- and age-specific obesity rates from 2006, 2009, 2012 and 2015.
Of childhood cancer survivors, 9.5% self-reported having obesity compared with an expected obesity rate of 12.5% in the general population (P = .0001). The percentage of people with a normal BMI was 63% for childhood cancer survivors compared with 49% among the general population. Cancer survivors who were treated for a central nervous system tumor had a higher prevalence of obesity than the general population (20.9% vs. 12%; P = .00001).
In multivariable analysis, childhood cancer survivors who received etoposide treatment had a higher likelihood for obesity than those who did not receive etoposide (RR = 1.7; 95% CI, 1.1-2.6). Most participants who received etoposide had peripheral nervous cell tumors, central nervous system tumors or lymphoma.
People who received radiation to the pituitary gland had an increased risk for obesity compared with those who did not receive radiation therapy. The obesity risk climbed as radiation dose increased. Each 1 Gy of radiation dose to the pituitary gland increased the risk of obesity by 4.8%.
Brain tumor survivors were more likely to have obesity than survivors of other cancers (RR = 1.9; 95% CI, 1.2-2.8) as well as the general population. Among those with height and weight available at cancer diagnosis, those with a BMI in the highest quartile at diagnosis had a higher risk for obesity than those in the lowest quartile (RR = 4.3; 95% CI, 2.6-7.1). Participants who were in two highest quartiles for social deprivation according to the French social deprivation index from 2009 had a higher risk for obesity than those in the lowest social deprivation quartile (RR = 1.9; 95% CI, 1.4-2.7).
“Regular monitoring of BMI in patients with childhood cancer appears to be essential in view of the higher risk of life-threatening conditions, especially for patients who had overweight at the time of diagnosis, those who have received a dose of pituitary irradiation of > 5 Gy or etoposide, and/or those who have had a brain tumor,” the researchers concluded.
Collapse
Read more about
Click Here to Manage Email Alerts