The use of specific antidepressants, in addition to more
well-known factors such as cancer treatment and lifestyle factors, may
contribute to the increased likelihood for obesity seen among childhood cancer
survivors, according to results from the Childhood Cancer Survivor Study.
Researchers identified more than 20,000 patients aged
younger than 21 years who were diagnosed with cancer between 1970 and 1986.
Patients had to have survived for at least 5 years from the time of diagnosis.
At the completion of the follow-up 2003 questionnaire, only 9,284 patients were
included in the analysis. The primary outcome of this analysis was BMI.
When looking at the patient population as a whole, 13.8%
of patients were using antidepressants, 27.99% met the CDC guidelines for
physical activity and 22.79% reported no physical activity in the previous
month. Patients most frequently reported using fluoxetine, sertraline and
Researchers identified several independent risk factors
for obesity, including cancer diagnosed between ages 5 and 9 years (RR=1.12;
95% CI, 1.01-1.24) and hypothalamic/pituitary radiation doses of 20 Gy to 30 Gy
(RR=0.17; 95% CI, 1.05-1.30). In addition, use of the antidepressant paroxetine
was independently associated with an increased risk for obesity (RR=1.29; 95%
The adverse health implications of obesity may be
greater among childhood cancer survivors whose exposures place them at an
increased risk for severe and life-threatening chronic health conditions,
the researchers wrote. Understanding the factors that contribute to
obesity in childhood cancer survivors, either directly or as mediators and
moderators, can facilitate clinical management.
For more information:
- Green DM. J Clin Oncol. 2011;30:245-255.
With steadily increasing progress in curing childhood
cancers, the adult survivors of childhood cancer now face important challenges
for their lifelong health. Some of the treatments we have used to cure cancer
in children can increase risk for conditions such as heart disease decades
later. Childhood cancer survivors need to be especially vigilant about their
cardiovascular disease risk by monitoring and controlling their blood pressure
and cholesterol levels, by eating heart-healthy foods, by being physically
active and by controlling body weight.
Tim Byers, MD, MPH
Associate dean for public health practice
Colorado School of Public Health
Disclosure: Dr. Byers reports no relevant financial