ISSN 1662-4009 (Online)

ESPE Yearbook of Paediatric Endocrinology (2019) 16 9.4 | DOI: 10.1530/ey.16.9.4

Diabetes risk in childhood cancer survivors: A population-based study

Lega IC, Pole JD, Austin PC, Lau C, Nathan PC & Baxter NN

To read the full abstract: Can J Diabetes. 2018 Oct; 42(5): 533.

This retrospective population-based study focused on diabetes prevalence in childhood cancer survivors (CCSs) using administrative health care databases of the Canadian National Health System. The authors compared 10,438 CCSs (mean age 10.7±6.8 years; mean follow-up time 11.2±6.9 years) with 52,190 age- and sex-matched controls. CCSs had a 55% higher rate of developing diabetes than matched controls. Diabetes was more common in CCSs with cancer diagnosis between 6 and 10 years of age, and in patients treated for leukaemia or lymphoma. CCSs developed diabetes at an earlier age than matched controls. This difference was more evident in males and was confirmed after exclusion of confounding factors, such as income, rurality, age at cancer diagnosis and year of cancer diagnosis.

This large study highlights the importance of regular diabetes screening during long-term follow up of CCSs (1–2). The study has some limitations: concurrent factors potentially affecting the risk of diabetes, as specific cancer treatments, obesity, lifestyle, relapses and/or associated comorbidities were not analyzed. Further studies are needed in order to clinically characterize CCSs who are at higher risk of diabetes and need regular and lifelong metabolic screening.

References: 1. Meacham LR, Sklar CA, Li S, Liu Q, Gimpel N, Yasui Y, Whitton JA, Stovall M, Robison LL, Oeffinger KC. Diabetes mellitus in long-term survivors of childhood cancer. Increased risk associated with radiation therapy: a report for the childhood cancer survivor study. Arch Intern Med. 2009 Aug 10; 169: 1381–1388.

2. Holmqvist AS, Olsen JH, Andersen KK, de Fine Licht S, Hjorth L, Garwicz S, Moëll C, Anderson H, Wesenberg F, Tryggvadottir L, Malila N, Boice JD Jr, Hasle H, Winther JF; ALiCCS study group. Adult life after childhood cancer in Scandinavia: diabetes mellitus following treatment for cancer in childhood. Eur J Cancer. 2014 Apr; 50: 1169–1175.

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