Cardiovascular risk factors in adult survivors of pediatric cancer--a report from the childhood cancer survivor study.
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 > or =30 kg/m(2) 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 [> or =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.
Meacham
Lillian R
LR
Aflac Cancer Center, Emory University, Hematology/Oncology and Endocrinology, 2015 Uppergate Drive Northeast, Atlanta, GA 30322, USA. Lmeacha@emory.edu
Chow
Eric J
EJ
Ness
Kirsten K
KK
Kamdar
Kala Y
KY
Chen
Yan
Y
Yasui
Yutaka
Y
Oeffinger
Kevin C
KC
Sklar
Charles A
CA
Robison
Leslie L
LL
Mertens
Ann C
AC
D000328:Adult; D018943:Anthracyclines / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D016017:Odds Ratio; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D017741:Survivors
D018943:Anthracyclines; D000970:Antineoplastic Agents