TY - JOUR
T1 - Metabolic syndrome in childhood, adolescent, and young adult cancer survivors
T2 - recommendations for surveillance from the International Late Effects of Childhood Cancer Guideline Harmonization Group
AU - van den Oever, Selina R
AU - Mulder, Renée L
AU - Oeffinger, Kevin C
AU - Gietema, Jourik A
AU - Skinner, Roderick
AU - Constine, Louis S
AU - Wallace, W Hamish
AU - Armenian, Saro
AU - Barnea, Dana
AU - Bardi, Edit
AU - Belle, Fabiën N
AU - Brown, Austin L
AU - Chemaitilly, Wassim
AU - Crowne, Liz
AU - van Dalen, Elvira C
AU - Denzer, Christian
AU - Ehrhardt, Matthew J
AU - Felicetti, Francesco
AU - Friedman, Danielle N
AU - Fulbright, Joy
AU - Glaser, Adam W
AU - Giwercman, Aleksander
AU - Sangstuen Haugnes, Hege
AU - Hayek, Samah
AU - Hennewig, Ulrike
AU - van den Heuvel-Eibrink, Marry M
AU - Haupt, Riccardo
AU - van Iersel, Laura
AU - Kamdar, Kala
AU - Lefrandt, Joop
AU - Levitt, Gill
AU - Morsellino, Vera
AU - Mulrooney, Daniel A
AU - Murray, Robert D
AU - Neggers, Sebastian
AU - Ness, Kirsten K
AU - Neville, Kristen A
AU - Nock, Nora L
AU - Otth, Maria
AU - Prasad, Pinki K
AU - van Santen, Hanneke M
AU - Schindera, Christina
AU - Rath, Shoshana R
AU - Steinberger, Julia
AU - Terenziani, Monica
AU - Varedi, Mitra
AU - Walwyn, Thomas
AU - Wei, Christina
AU - Hudson, Melissa M
AU - Kremer, Leontien C M
AU - Nuver, Janine
AU - Tonorezos, Emily
N1 - © The Author(s) 2025. Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].
PY - 2025/4
Y1 - 2025/4
N2 - OBJECTIVE: Survivors of childhood, adolescent, and young adult (CAYA) cancer have an increased risk of metabolic syndrome (MetS). MetS describes the clustering of cardiovascular risk factors including overweight or obesity, hypertension, impaired glucose tolerance, and hyperlipidaemia. While associated cardiovascular sequelae can be serious, MetS is preventable, manageable and potentially reversible with the appropriate pharmacological and/or behavioral interventions. To optimise health outcomes in CAYA cancer survivors, international, harmonised surveillance recommendations are essential.DESIGN: Systematic review and guideline development.METHODS: A multidisciplinary guideline panel evaluated concordances and discordances across national guidelines for MetS surveillance and performed a systematic literature review. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to grade the available evidence and formulate recommendations considering the strength of the underlying evidence as well as potential harms and benefits associated with MetS surveillance. In case evidence was lacking, recommendations were based on expert opinion. In addition, recommendations for surveillance modalities were derived from existing guidelines for MetS components where applicable.RESULTS: The systematic literature review included 20 studies and highlighted two high-risk groups, namely CAYA cancer survivors treated with total body irradiation and those treated with cranial or craniospinal irradiation (moderate-quality evidence). Recommendations were formulated for MetS surveillance in these risk groups, covering preferred screening modalities, age at screening initiation and surveillance frequency.CONCLUSIONS: In this international surveillance guideline for MetS in CAYA cancer survivors we provide evidence-based recommendations for clinical practice, with the aim of ensuring optimal MetS surveillance for CAYA cancer survivors.
AB - OBJECTIVE: Survivors of childhood, adolescent, and young adult (CAYA) cancer have an increased risk of metabolic syndrome (MetS). MetS describes the clustering of cardiovascular risk factors including overweight or obesity, hypertension, impaired glucose tolerance, and hyperlipidaemia. While associated cardiovascular sequelae can be serious, MetS is preventable, manageable and potentially reversible with the appropriate pharmacological and/or behavioral interventions. To optimise health outcomes in CAYA cancer survivors, international, harmonised surveillance recommendations are essential.DESIGN: Systematic review and guideline development.METHODS: A multidisciplinary guideline panel evaluated concordances and discordances across national guidelines for MetS surveillance and performed a systematic literature review. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to grade the available evidence and formulate recommendations considering the strength of the underlying evidence as well as potential harms and benefits associated with MetS surveillance. In case evidence was lacking, recommendations were based on expert opinion. In addition, recommendations for surveillance modalities were derived from existing guidelines for MetS components where applicable.RESULTS: The systematic literature review included 20 studies and highlighted two high-risk groups, namely CAYA cancer survivors treated with total body irradiation and those treated with cranial or craniospinal irradiation (moderate-quality evidence). Recommendations were formulated for MetS surveillance in these risk groups, covering preferred screening modalities, age at screening initiation and surveillance frequency.CONCLUSIONS: In this international surveillance guideline for MetS in CAYA cancer survivors we provide evidence-based recommendations for clinical practice, with the aim of ensuring optimal MetS surveillance for CAYA cancer survivors.
U2 - 10.1093/ejendo/lvaf046
DO - 10.1093/ejendo/lvaf046
M3 - Article
C2 - 40103414
SN - 0804-4643
VL - 192
SP - S27-S40
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
IS - 4
ER -