What's new in the childhood cancer registry?

Overweight in childhood cancer patients at diagnosis and throughout therapy: a multicentre cohort study

• Children treated for cancer were more often overweight at the end of treatment (13%) compared to when they started treatment (8%).

• Boys and patients suffering from leukaemia or lymphoma were more likely to gain weight during treatment.

• Leukaemia and lymphoma patients gained weight during the entire treatment period. Within leukaemia patients the highest weight gain was seen at start of treatment.

Research question:

We wanted to find out how many children treated for cancer were overweight at diagnosis and at the end of treatment. We also wanted to know which children were most at risk to become overweight during treatment. Finally, we looked when weight gain occurred during treatment.

Why is this important?:

Previous studies suggest that childhood cancer patients are at high risk to become overweight during cancer treatment. Overweight increases the risk to develop chronic diseases like diabetes and cardiovascular diseases later in life. Previous studies have focused mainly on patients with leukaemia and brain tumours but not on other types of cancer.

What did we do?:

We measured patients’ height and weight at diagnosis and repeatedly during treatment in three childhood cancer centres in Switzerland: Basel, Bern, and Zurich. We calculated the patients’ body mass index by dividing weight by height squared (kg/m2) at time of diagnosis and throughout treatment. To define overweight we used the reference values of the International Obesity Taskforce. We looked how often patients were overweight at diagnosis and at end of treatment. We assessed which children were most at risk to become overweight. We also described when weight gain occurred during treatment by cancer type.

What did we find?:

We included 327 childhood cancer patients who were aged between 3 and 12 years at diagnosis. At diagnosis, 27 patients (8%) were overweight. This increased to 43 patients (13%) at end of treatment. Boys and patients suffering from leukaemia or lymphoma were more likely to gain weight during treatment. Leukaemia and lymphoma patients gained weight during the entire treatment period, but the highest weight gain was at the start of treatment.

What does this mean and reasons for caution?:

We found that mainly patients diagnosed with leukaemia or lymphoma gained weight during treatment. Weight monitoring during treatment should thus focus on patients with these diagnoses. However, another study conducted in long-term survivors in Switzerland, suggested that the effect is not long-lasting; as it found that later (12 to 22 years after diagnosis) former childhood cancer patients were not more likely to be overweight than their siblings or the general Swiss population. 

More information:

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

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

Clinical Nutrition, 2018, doi: 10.1016/j.clnu.2018.02.022

 

 

© ISPM - University of Bern 2016