What's new in the childhood cancer registry?

No evidence for overweight in long-term childhood cancer survivors after glucocorticoid treatment

•Former childhood cancer patients in Switzerland are not more likely to become overweight than persons who never had cancer.

•We found no evidence to suggest that corticosteroid treatment leads to overweight in the long-term

Research question:

This analysis from the Swiss Childhood Cancer Survivor Study investigated if former childhood cancer patients who had been treated with high doses of corticosteroids had a higher risk to become overweight than those patients who received lower doses. We also compared two different types of corticosteroids to see if they had a different effect on overweight development long after diagnosis.

Why is this important?:

Corticosteroids can lead to short-term weight gain during cancer treatment. However, it is unclear if this effect is long-lasting.  This study is important since overweight increases the risk to develop chronic diseases like diabetes, hypertension, and cardiovascular disease.  

What did we do?:

To assess overweight, we sent a questionnaire in Switzerland to former childhood cancer patients diagnosed since 1976. We calculated body mass index (weight divided by height squared [kg/m2]) at the time of diagnosis and at the time of survey. We defined overweight as ≥25 kg/m2. We looked how often former childhood cancer patients were overweight and compared this with their siblings and the general population. To assess corticosteroid treatment, we went through the medical records of all former childhood cancer patients. We looked if there was a relationship between the total corticosteroid dose given during treatment and overweight at the time of the study. We also compared two types of corticosteroids.

What did we find?:

We included 1936 former childhood cancer patients, 725 siblings, and 9,591 persons from the general population. At survey (in average 17 years after diagnosis) 26% of the former cancer patients were overweight. This percentage was similar to what we observed among their siblings and the general Swiss population. Former childhood cancer patients had a similar risk to become overweight whether or not they had received high-dose corticosteroids during their cancer treatment. We found no difference between the two types of corticosteroids. Only former patients who had been treated with radiation to the brain were more often overweight.

What does this mean and reasons for caution?:

We did not find evidence that treatment with high-dose corticosteroids increases the risk to be overweight in the long-term (12-22 years after diagnosis); former childhood cancer patients treated with corticosteroids were not more likely to be overweight than their siblings or the general population.

What’s next?:

We will now do a study together with researchers from the United States in which we will compare the results from both countries. We want to find out why former leukaemia patients in the United States are more overweight than in Switzerland.

More information:

Fabiën Belle: fabien.belle[at]ispm.unibe.ch

Claudia Kuehni: claudia.kuehni[at]ispm.unibe.ch

Cancer. 2018;124:3576-85, doi: 10.1002/cncr.31599

© ISPM - University of Bern 2019