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Factors associated with obesity in childhood cancer survivors identified
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The use of specific antidepressants, in addition to more well-known factors such as cancer treatment and lifestyle factors, may contribute to the increased likelihood for obesity seen among childhood cancer survivors, according to results from the Childhood Cancer Survivor Study.
Researchers identified more than 20,000 patients aged younger than 21 years who were diagnosed with cancer between 1970 and 1986. Patients had to have survived for at least 5 years from the time of diagnosis. At the completion of the follow-up 2003 questionnaire, only 9,284 patients were included in the analysis. The primary outcome of this analysis was BMI.
When looking at the patient population as a whole, 13.8% of patients were using antidepressants, 27.99% met the CDC guidelines for physical activity and 22.79% reported no physical activity in the previous month. Patients most frequently reported using fluoxetine, sertraline and paroxetine antidepressants.
Researchers identified several independent risk factors for obesity, including cancer diagnosed between ages 5 and 9 years (RR=1.12; 95% CI, 1.01-1.24) and hypothalamic/pituitary radiation doses of 20 Gy to 30 Gy (RR=0.17; 95% CI, 1.05-1.30). In addition, use of the antidepressant paroxetine was independently associated with an increased risk for obesity (RR=1.29; 95% CI, 1.08-1.54).
“The adverse health implications of obesity may be greater among childhood cancer survivors whose exposures place them at an increased risk for severe and life-threatening chronic health conditions,” the researchers wrote. “Understanding the factors that contribute to obesity in childhood cancer survivors, either directly or as mediators and moderators, can facilitate clinical management.”
For more information:
- Green DM. J Clin Oncol. 2011;30:245-255.
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With steadily increasing progress in curing childhood cancers, the adult survivors of childhood cancer now face important challenges for their lifelong health. Some of the treatments we have used to cure cancer in children can increase risk for conditions such as heart disease decades later. Childhood cancer survivors need to be especially vigilant about their cardiovascular disease risk by monitoring and controlling their blood pressure and cholesterol levels, by eating heart-healthy foods, by being physically active and by controlling body weight.
– Tim Byers, MD, MPH
Associate dean for public health practice
Colorado School of Public Health
Disclosure: Dr. Byers reports no relevant financial disclosures.