Pediatric cancer survivors at increased risk for predisposing factors for cardiovascular disease

Childhood cancer survivors seem to be predisposed to obesity, dyslipidemia, diabetes and hypertension, all defined as component risk factors for Cardiovascular Risk Factor Cluster, a surrogate of metabolic syndrome.

The risk for developing these cardiovascular risk factors was associated with older age, certain kinds of radiation exposure and physical inactivity.

Researchers examined 8,599 childhood cancer survivors and 2,936 siblings enrolled in the Childhood Cancer Survivor Study. Cancer survivors had lived five years after pediatric cancer diagnosis between 1970 and 1986.

Study participants were evaluated for BMI ≥30 based on self-reported heights and weights, as well as the self-reported use of medications for hypertension, dyslipidemia and impaired glucose metabolism. The presence of three or more risk factors was designated by the researchers as Cardiovascular Risk Factor Cluster (CVRFC).

According to the study results, there was no difference in prevalence of obesity between survivors and siblings. However, after adjustment for age, ethnicity and sex, the researchers reported that compared with siblings, survivors were 1.9 times more likely to be taking medications for hypertension (95% CI, 1.6-2.2), 1.6 times more likely to be taking medications for dyslipidemia (95% CI, 1.3-2.0) and 1.7 (95% CI, 1.2-2.3) times more likely to be taking medication for diabetes. Despite this, survivors were equally likely to meet criteria for CVRFC as their siblings (OR=1.3; 95% CI, 0.9=1.9).

Following multivariable logistical regression analysis, age at the time of interview (OR=8.2; 95% CI, 3.5-19.9), exposure to total body irradiation (OR=5.5; 95% CI, 1.5-15.8), radiation of the chest and abdomen (OR=2.3; 95% CI, 1.2-2.4) and physical inactivity (OR=1.7; 95% CI, 1.1-2.6) were all associated with having CVRFC.

Meacham L. Cancer Epidemiol Biomarkers Prev. 2010;19:170-181.