Obesity in survivors of childhood cancer.

PURPOSE: Several studies reported previously increased risk for obesity in childhood cancer survivors (CCS). The objectives of this article were to evaluate the rate of overweight and obesity in CCS compared to the general population, to identify possible risk factors for obesity in these patients, and to assess changes in weight status over time.

METHODS

A historical cohort including all patients (n=820) treated at a tertiary center over a twenty-year period, who were diagnosed with cancer at age <18 years, and had at least one year of follow-up after completion of anti-cancer treatment.

RESULTS

Higher rates of overweight/obesity were observed in the CCS cohort compared to the general population. Weight status at the time of diagnosis (OR=1.69 95%CI 1.38-2.07, p<0.01), endocrine dysfunctions (OR=1.46, 95%CI 1.08-1.98, p=0.01), and age at diagnosis were identified as significant risk factors for overweight/obesity in CCS. Treatment with radiation alone had a close to significant effect (OR=1.8 95%. CI 0.91-3.53, p=0.09) on overweight/obesity. Rates of overweight/obesity peaked 3-5 years after diagnosis (OR=1.3, 95% CI 1.11-1.53, p<0.01) and declined thereafter.

CONCLUSION

Better understanding of possible risk factors and characterization of high-risk groups of patients may assist in planning appropriate interventions that might decrease obesity and related morbidity in CCS.