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Body Mass Index, Physical Activity, and Subsequent Neoplasm Risk Among Childhood Cancer Survivors.

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Area of Science:

  • Oncology
  • Epidemiology
  • Public Health

Background:

  • High body mass index (BMI) and low physical activity are known risk factors for adult cancers.
  • Limited data exist on the association between BMI, physical activity, and subsequent neoplasms in childhood cancer survivors.

Purpose of the Study:

  • To investigate the relationship between time-varying body mass index (BMI) and physical activity levels with the risk of developing subsequent neoplasms in childhood cancer survivors.

Main Methods:

  • A retrospective cohort analysis of 22,716 childhood cancer survivors from the Childhood Cancer Survivor Study (CCSS) was conducted.
  • Self-reported, time-varying BMI and physical activity (MET-h/wk) were assessed up to six times post-diagnosis.
  • Statistical models estimated cumulative incidence and relative rates (RRs) for subsequent neoplasms, adjusted for covariates.

Main Results:

  • Obesity was linked to increased incidence rates of solid organ, central nervous system (CNS), and skin neoplasms.
  • Higher physical activity (15-21 MET-h/wk) was associated with a reduced risk of overall subsequent neoplasms, as well as solid organ, CNS, and skin neoplasms.
  • Specific associations were found for meningiomas and thyroid carcinomas, but not for breast, colorectal, or hematologic neoplasms.

Conclusions:

  • Obesity increases the risk of various subsequent neoplasms in childhood cancer survivors.
  • Higher levels of physical activity are associated with a reduced risk of subsequent neoplasms in this population.
  • Future research should explore lifestyle interventions for the prevention of subsequent neoplasms in childhood cancer survivors.