Clinical nutrition ESPEN · 2026
The association between cancer history and long-term body composition based on a 10-year follow-up.
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Wu Yong-Jun, Wang Chuan-Si, Zhang Yong-Gui, Wei Hai-Hong
Аннотация
BACKGROUND: Cancer survivors often face long-term health challenges, including alterations in body composition. This study investigates the impact of cancer history on long-term body composition using data from the National Health and Nutrition Examination Survey (NHANES).
METHODS: The clinical data of cancer survivors were obtained from the NHANES spanning 1999-2006. Participants were categorized into two groups based on their cancer history. To minimize baseline differences and enhance comparability between groups, propensity score matching (PSM) was employed. Kaplan-Meier survival analysis was conducted to evaluate the impact of lean mass and fat mass on overall mortality.
RESULTS: Before matching, a total of 13,213 patients were included in the analysis, comprising 391 cancer survivors with a history of cancer exceeding 10 years (cancer history group) and 12,822 individuals with no prior cancer diagnosis (non-cancer history group). Cancer survivors were significantly older (67 years vs. 45 years, P < 0.001) and had a higher proportion of females (62.4 % vs. 48.6 %, P < 0.001) compared to those without cancer history. After propensity score matching, key baseline characteristics were well-balanced between the two groups, with no significant differences observed. The matched data further revealed that cancer survivors exhibited a significantly higher fat mass (27.03 kg vs. 20.44 kg, P < 0.001) and fat mass proportion (36.3 % vs. 30.8 %, P < 0.001). Although lean mass also showed an increase (45.88 kg vs. 41.27 kg, P < 0.001), a low lean mass index was associated with shorter survival (P = 0.021). Notably, cancer survivors with both a low lean mass index and a high fat mass index had the highest mortality risk.
CONCLUSION: A history of cancer continues to exert long-term adverse effects on body composition, characterized primarily by abnormal fat accumulation, although higher lean mass is also observed. Understanding of long-term body composition characteristics in cancer survivors is essential for elucidating the metabolic consequences of cancer and its treatment.
METHODS: The clinical data of cancer survivors were obtained from the NHANES spanning 1999-2006. Participants were categorized into two groups based on their cancer history. To minimize baseline differences and enhance comparability between groups, propensity score matching (PSM) was employed. Kaplan-Meier survival analysis was conducted to evaluate the impact of lean mass and fat mass on overall mortality.
RESULTS: Before matching, a total of 13,213 patients were included in the analysis, comprising 391 cancer survivors with a history of cancer exceeding 10 years (cancer history group) and 12,822 individuals with no prior cancer diagnosis (non-cancer history group). Cancer survivors were significantly older (67 years vs. 45 years, P < 0.001) and had a higher proportion of females (62.4 % vs. 48.6 %, P < 0.001) compared to those without cancer history. After propensity score matching, key baseline characteristics were well-balanced between the two groups, with no significant differences observed. The matched data further revealed that cancer survivors exhibited a significantly higher fat mass (27.03 kg vs. 20.44 kg, P < 0.001) and fat mass proportion (36.3 % vs. 30.8 %, P < 0.001). Although lean mass also showed an increase (45.88 kg vs. 41.27 kg, P < 0.001), a low lean mass index was associated with shorter survival (P = 0.021). Notably, cancer survivors with both a low lean mass index and a high fat mass index had the highest mortality risk.
CONCLUSION: A history of cancer continues to exert long-term adverse effects on body composition, characterized primarily by abnormal fat accumulation, although higher lean mass is also observed. Understanding of long-term body composition characteristics in cancer survivors is essential for elucidating the metabolic consequences of cancer and its treatment.