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

Cancer Epidemiol Biomarkers Prev. 2010 Jan;19(1):170-81. doi: 10.1158/1055-9965.EPI-09-0555.


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.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anthracyclines / adverse effects
  • Antineoplastic Agents / adverse effects
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology*
  • Child
  • Confidence Intervals
  • Female
  • Humans
  • Male
  • Neoplasms / complications*
  • Neoplasms / therapy
  • Odds Ratio
  • Radiotherapy / adverse effects
  • Risk Factors
  • Survivors


  • Anthracyclines
  • Antineoplastic Agents