Modifiable Cardiometabolic Risk Factors in Survivors of Childhood Cancer
Rawan Hammoud, Daniel A. Mulrooney, Isaac Rhea, Christine Yu, Jason N. Johnson, Eric J. Chow, Matthew J. Ehrhardt, Melissa M. Hudson, Kirsten K. Ness, Gregory T. Armstrong, Stephanie B. Dixon
Abstract
The growing community of childhood cancer survivors faces a heavy burden of late onset morbidities and mortality, with cardiovascular diseases being the leading noncancer cause. In addition to demographics and cancer treatment exposures, which cannot be altered, cardiometabolic risk factors (obesity, hypertension, diabetes, and dyslipidemia) and frailty potentiate the risk of morbidity and mortality associated with chronic health conditions. Important opportunities exist to target these risk factors and improve late health outcomes for survivors. Unfortunately, limited evidence exists on the optimal methods to prevent, screen, and treat cardiometabolic risk factors among survivors, resulting in significant underdiagnosis and undertreatment. In this review, we discuss the prevalence of, risk factors for, current survivor-specific recommendations, and gaps in knowledge to mitigate potentially modifiable cardiometabolic risk factors and frailty among survivors of childhood cancer. • Cardiometabolic risk factors and frailty increase the risk of morbidity and health-related mortality among survivors of childhood cancer. • These conditions are important targets for interventions but remain underdiagnosed and/or undertreated in this population. • Survivorship research should focus on determining the optimal prevention, screening, and treatment modalities for cardiometabolic disease.