Cardiovascular risk factors in adult survivors of pediatric cancer-a report from the childhood cancer survivor study Journal Article


Authors: Meacham, L. R.; Chow, E. J.; Ness, K. K.; Kamdar, K. Y.; Chen, Y.; Yasui, Y.; Oeffinger, K. C.; Sklar, C. A.; Robison, L. L.; Mertens, A. C.
Article Title: Cardiovascular risk factors in adult survivors of pediatric cancer-a report from the childhood cancer survivor study
Abstract: Background: Childhood cancer survivors are at higher risk of morbidity and mortality from cardiovascular disease compared with the general population. Methods: Eight thousand five hundred ninety-nine survivors (52% male) and 2,936 siblings (46% male) from the Childhood Cancer Survivor Study, a retrospectively ascertained, prospectively followed study of persons who survived 5 years after childhood cancer diagnosed from 1970 to 1986, were evaluated for body mass index of ≥30 kg/m2 based on self-reported heights and weights and self-reported use of medications for hypertension, dyslipidemia, and impaired glucose metabolism. The presence of three or more of the above constituted Cardiovascular Risk Factor Cluster (CVRFC), a surrogate for Metabolic Syndrome. Results: Survivors were more likely than siblings to take medications for hypertension [odds ratio (OR), 1.9; 95% confidence interval (95% CI), 1.6-2.2], dyslipidemia (OR, 1.6; 95% CI, 1.3-2.0) or diabetes (OR, 1.7; 95% CI, 1.2-2.3). Among these young adults (mean age of 32 years for survivors and 33 years for siblings), survivors were not more likely than siblings to be obese or have CVRFC. In a multivariable logistic regression analysis, factors associated with having CVRFC included older age at interview [≥40 versus <30 years of age (OR, 8.2; 95% CI, 3.5-19.9)], exposure to total body irradiation (OR, 5.5; 95% CI, 1.5-15.8) or radiation to 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). Conclusions: Among adult survivors of pediatric cancer, older attained age, exposure to total body irradiation or abdominal plus chest radiation, and a sedentary life-style are associated with CVRFC. ©2010 AACR.
Keywords: adult; child; major clinical study; hypertension; antineoplastic agents; neoplasms; radiotherapy; odds ratio; risk factors; body weight; obesity; risk factor; childhood cancer; radiation exposure; cancer survivor; survivors; confidence intervals; survival time; body mass; whole body radiation; abdomen; cardiovascular risk; cardiovascular diseases; antidiabetic agent; antihypertensive agent; antilipemic agent; body height; dyslipidemia; metabolic syndrome x; high risk population; anthracyclines; drug use; immobilization; lifestyle; thorax; glucose metabolism; impaired glucose tolerance
Journal Title: Cancer Epidemiology Biomarkers and Prevention
Volume: 19
Issue: 1
ISSN: 1055-9965
Publisher: American Association for Cancer Research  
Date Published: 2010-01-01
Start Page: 170
End Page: 181
Language: English
DOI: 10.1158/1055-9965.epi-09-0555
PUBMED: 20056636
PROVIDER: scopus
PMCID: PMC2805162
DOI/URL:
Notes: --- - "Cited By (since 1996): 5" - "Export Date: 20 April 2011" - "CODEN: CEBPE" - "Source: Scopus"
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MSK Authors
  1. Charles A Sklar
    299 Sklar
  2. Kevin Oeffinger
    280 Oeffinger