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Obesity and Risk for Second Malignant Neoplasms in Childhood Cancer Survivors: A Case-Control Study Utilizing the California Cancer Registry
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July 23 2019
Source: Cancer Epidemiol Biomarkers Prev. 28(10):1612-1620
Details:
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Alternative Title:Cancer Epidemiol Biomarkers Prev
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Personal Author:
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Description:Background:
Obesity is a known modifiable risk factor associated with adverse outcomes in children with cancer. We sought to determine if obesity during childhood cancer treatment increases risk for second malignant neoplasms (SMNs).
Methods:
In this case-control study, cases (with SMN) and controls (with a single primary cancer) were selected from the California Cancer Registry who had primary cancer diagnosed <21 years treated at Children’s Hospital Los Angeles (CHLA) between 1988–2014. Controls were matched 3:1 to cases at the registry level by clinical factors. Medical records were abstracted for cancer treatment exposures, cancer predisposition syndrome, body mass index (BMI), BMI Z-score, and BMI category at diagnosis and EOT.
Results:
Fifty-nine cases and 130 controls were included. Median age at primary cancer diagnosis was 6 years, 64.5% were male, median time from primary cancer to SMN was 7.5 years, and 31.7% were obese or overweight. In matched multivariable analyses, there were elevated but non-significant associations between SMN and higher BMI Z-score at diagnosis (OR 1.27 [0.99–1.63]) and higher BMI categories at diagnosis (adjusted OR [aOR] overweight 1.25 [0.55–2.52]; aOR obese 2.51 [1.00–6.29]). There was a significantly increased risk for SMN among patients who were obese at both diagnosis and EOT (aOR 4.44 [1.37–14.34]).
Conclusions:
This study suggests obesity during childhood cancer treatment may be associated with increased risk for SMNs, particularly among those obese throughout therapy.
Impact:
Additional studies to confirm these findings and to develop interventions have the potential to impact SMN development in children with cancer.
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Pubmed ID:31337641
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Pubmed Central ID:PMC6774883
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