title: Body mass index in long-term adult survivors of childhood cancer: a report of the Childhood Cancer Survivor Study.
abstract: BACKGROUND
  The goals of the current study were to determine the distribution of body mass index (BMI) of survivors of common pediatric malignancies and to identify factors associated with abnormal BMI.
  
  
  METHODS
  The Childhood Cancer Survivor Study (CCSS) is a multicenter cohort study of >/= 5-year survivors of pediatric cancer diagnosed between 1970 and 1986. Self-reported heights and weights were used to calculate BMI for 7195 adult survivors, compared with population-based, age-specific, and gender-specific norms from the 1995 National Health Interview Survey. Underweight was defined as a BMI < 18.5 kg/m(2) and obese as BMI >/= 30 kg/m(2).
  
  
  RESULTS
  Survivors of leukemia were more likely to be obese (females: odds ratio [OR] = 1.5; 95% confidence interval [CI], 1.2-1.8; males: OR = 1.2; 95% CI, 1.0-1.5). Survivors more likely to be underweight included female and male survivors of Hodgkin disease (OR = 1.7; 95% CI, 1.3-2.3 and OR = 3.5; 95% CI, 2.3-5.3) and Wilms tumor (OR = 1.8; 95% CI, 1.2-2.8 and OR = 5.5; 95% CI, 3.1-9.7), female survivors of bone carcinoma without amputation (OR = 1.9; 95% CI, 1.2-2.9), and male survivors of leukemia (OR = 2.4; 95% CI, 1.6-3.6), brain tumors (OR = 2.7; 95% CI, 1.6-4.4), non-Hodgkin lymphoma (OR = 3.1; 95% CI, 1.9-5.2), neuroblastoma (OR = 4.9; 95% CI, 2.48-10.0), and soft tissue sarcoma (OR = 3.5; 95% CI, 2.0-6.0). In females, treatment with total body irradiation, alkylating agents, and anthracyclines and in males, treatment with abdominal radiation, younger age at treatment, and treatment with anthracyclines and alkylating agents were associated with being underweight. Underweight survivors were more likely to report adverse health and major medical conditions.
  
  
  CONCLUSIONS
  A significant proportion of childhood survivors of cancer are underweight as adults and the impact of this on the general health of survivors will need to be addressed further.
authors.affiliation: Department of Pediatrics, Emory University, Atlanta, Georgia 30322, USA. Lillian_Meacham@oz.ped.emory.edu
authors.forename: Lillian R
authors.initials: LR
authors.lastname: Meacham
authors.forename: James G
authors.initials: JG
authors.lastname: Gurney
authors.forename: Ann C
authors.initials: AC
authors.lastname: Mertens
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.forename: Charles A
authors.initials: CA
authors.lastname: Sklar
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Oeffinger
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000473:pathology*; D016017:Odds Ratio; D012189:Retrospective Studies; D017741:Survivors