Predictors of Overweight and Obesity in Childhood Cancer Survivors

Gance‐Cleveland, Bonnie; Arbet, Jaron; Stiller, Debra; Sylvain, Genevieve

doi:10.1177/1043454219897102

Cited by 9 publications

(8 citation statements)

References 24 publications

(41 reference statements)

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“…In the GFP, the proportion of children with obesity aged 5 to 12 years increased from 6% in the late 1970s to 13% in 1996 and it has stabilized since the 2000s [44]. Patients with obesity at cancer diagnosis are at high risk of being young adults with obesity, a phenomenon that has been described in the literature [6]. Moreover, we have chosen not to adjust for the lifestyle of the patients and for comorbidities during their lives because we were unable to know whether obesity occurred before or after comorbidities or lifestyle‐related events; the risk is of wrongly attributing a risk factor to the development of obesity when it is, in fact, a consequence of obesity, but also because these comorbidities are also linked to the same risk factors as obesity, which could lead to overadjustment.…”

Section: Discussionmentioning

confidence: 99%

“…Obesity secondary to hypothalamic-pituitary dysfunction, related to a tumor or surgery in the sellar region, is also a well-known risk factor [7,[9][10][11]. Other parameters have been studied in adult CCSs, independent of the oncological treatment, such as sex, the patient's social environment and status, ethnic origin, body mass index (BMI) at diagnosis, and young age at diagnosis [6,12,13]. Some of these studies presented contradictory results, illustrating the complex influence of the environment on the etiology of obesity.…”

Section: Introductionmentioning

confidence: 99%

“…Some risk factors predisposing to adult obesity have already been well identified in the literature. Among them is brain irradiation in patients with brain tumors or ALL, especially when the radiation dose is >20 Gy [6][7][8]. Obesity secondary to hypothalamic-pituitary dysfunction, related to a tumor or surgery in the sellar region, is also a well-known risk factor [7,[9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for obesity in adulthood among survivors of childhood cancer

Delacourt,

Allodji,

Chappat

et al. 2023

Obesity

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Objective The aim of this study was to identify risk factors for obesity in childhood cancer survivors (CCSs). Methods The study included 3199 patients of the French Childhood Cancer Survivor Study cohort, with 303 patients with obesity who had returned the self‐questionnaire. Analyses were adjusted for social deprivation index and sex. Results CCSs were less likely to have obesity (9.5%; 95% CI: 8.5%–10.5%) than expected from the general French population rates (12.5%; p = 0.0001). Nevertheless, brain tumor survivors were significantly more likely to develop obesity than the general French population (p = 0.0001). Compared with patients who did not receive radiotherapy to the pituitary gland, those who received a dose >5 Gy had an increased risk of obesity: relative risk 1.9 (95% CI: 1.2–3.1), 2.5 (95% CI: 1.7–3.7), and 2.6 (95% CI: 1.6–4.3), respectively, for participants with 6 to 20 Gy, 20 to 40 Gy, and ≥40 Gy of radiation. Etoposide administration significantly increased the risk of obesity (relative risk 1.7; 95% CI: 1.1–2.6). High social deprivation index was also a risk factor, just like BMI at diagnosis. Conclusions Long‐term follow‐up of CCSs should include weight follow‐up during adulthood.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors for obesity in adulthood among survivors of childhood cancer

Delacourt,

Allodji,

Chappat

et al. 2023

Obesity

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“…The type of chronic health condition disparities assessed for non-Hispanic Black survivors included vitamin-D deficiency (27), subsequent neoplasms (31), cardiovascular disorders (31), cardiovascular risks (38), and serious/life-threatening health conditions (43). The type of chronic health condition disparities assessed for Hispanic survivors included vitamin-D deficiency (27), obesity (29), subsequent neoplasm (31), endocrine condition (31) attainment, household income), and lifestyle health risk for chronic health conditions (BMI and cardiovascular risk factors including obesity, diabetes, hypertension and dyslipidemia).…”

Section: Disparities In Chronic Health Conditionsmentioning

confidence: 99%

“…Particularly for Hispanic survivors, family dynamics (e.g., language spoken at home) should be further investigated as they are potentially protective factors for poor patient-reported outcomes. In chronic health conditions, most articles found that racial/ethnic disparities remained statistically significant after risk modulators (e.g., clinical factors, individual demographic and SES factors, and cardiovascular risk factors) were included in the multivariable modeling (27,29,31,38,43). It is possible that underlying biological mechanisms (e.g., inherited genetic predisposition to disease risks and epigenetic modifications due to life experiences or environmental exposures) and disadvantaged neighborhood environments may elevate disparities in chronic health conditions beyond the influence of individual SES and clinical risk.…”

Section: Disparity-specific Risk Modulatorsmentioning

confidence: 99%

Racial and Ethnic Disparities in Health Outcomes Among Long-Term Survivors of Childhood Cancer: A Scoping Review

Reeves

Mathis

Bauer

et al. 2021

Front. Public Health

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The five-year survival rate of childhood cancer has increased substantially over the past 50 yr; however, racial/ethnic disparities in health outcomes of survival have not been systematically reviewed. This scoping review summarized health disparities between racial/ethnic minorities (specifically non-Hispanic Black and Hispanic) and non-Hispanic White childhood cancer survivors, and elucidated factors that may explain disparities in health outcomes. We used the terms “race”, “ethnicity”, “childhood cancer”, “pediatric cancer”, and “survivor” to search the title and abstract for the articles published in PubMed and Scopus from inception to February 2021. After removing duplicates, 189 articles were screened, and 23 empirical articles were included in this review study. All study populations were from North America, and the mean distribution of race/ethnicity was 6.9% for non-Hispanic Black and 4.5% for Hispanic. Health outcomes were categorized as healthcare utilization, patient-reported outcomes, chronic health conditions, and survival status. We found robust evidence of racial/ethnic disparities over four domains of health outcomes. However, health disparities were explained by clinical factors (e.g., diagnosis, treatment), demographic (e.g., age, sex), individual-level socioeconomic status (SES; e.g., educational attainment, personal income, health insurance coverage), family-level SES (e.g., family income, parent educational attainment), neighborhood-level SES (e.g., geographic location), and lifestyle health risk (e.g., cardiovascular risk) in some but not all articles. We discuss the importance of collecting comprehensive social determinants of racial/ethnic disparities inclusive of individual-level, family-level, and neighborhood-level SES. We suggest integrating these variables into healthcare systems (e.g., electronic health records), and utilizing information technology and analytics to better understand the disparity gap for racial/ethnic minorities of childhood cancer survivors. Furthermore, we suggest national and local efforts to close the gap through improving health insurance access, education and transportation aid, racial-culture-specific social learning interventions, and diversity informed training.

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