ArticlePediatric blood & cancer2024
Risk of increased mortality in underweight survivors: A brief report from the Childhood Cancer Survivor Study.
Article in Pediatric blood & cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Abnormal body weight and risk of gallbladder cancer: an updated meta-analysis incorporating recent evidence.BMC cancer · 2026Pooled it
- Pediatric doxorubicin exposure induces persistent pathological changes in mice.Toxicology and applied pharmacology · 2025Article
- Early Increase in Weight Is Seen During Treatment for Paediatric Acute Lymphoblastic Leukaemia-A Retrospective Analysis of Medical Records.Acta paediatrica (Oslo, Norway : 1992) · 2025Article
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13 authors.
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Abstract
backgroundApproximately 1 in 10 adult survivors of childhood cancer is underweight. Although the consequences of being overweight or obese have been well described, outcomes among childhood cancer survivors who are underweight are unknown.
objectiveTo determine whether underweight status increases the risk of mortality. PROCEDURE: Cohort study: Marginal models with generalized estimating equations to evaluate the associations between body mass index (BMI), serious or life-threatening chronic conditions, and death in the setting of long-term follow-up questionnaires and National Death Index search.
participantsChildhood cancer five-year survivors diagnosed during 1970-1986 in the Childhood Cancer Survivor Study Exposure: Underweight status, defined as body mass index (BMI) < 18.5 kg/m MAIN OUTCOMES: Overall mortality and cancer-specific mortality.
resultsOf 9454 survivors (median age 35 years old (range, 17-58), an average of 17.5 years from diagnosis), 627 (6.6%) participants were underweight at baseline or follow-up questionnaire. Of 184 deaths, 29 were among underweight survivors. Underweight status was more common among females (9.1% vs. 4.5%, p < .01) and participants with younger age at diagnosis (8.2% for < 5 years vs. 6.1% for ≥5 years, p < .01), lower household income (8.9% for < $20,000 vs. 6.0% for ≥ $20,000, p < .01), or a history of serious chronic condition (p = .05). After adjustment for these factors, in addition to prior smoking and a history of radiation therapy, the risk of all-cause mortality within two years of BMI report was increased (OR 2.85; 95% CI: 1.63-4.97; p < .01) for underweight survivors, compared with ideal-weight survivors.
conclusionsChildhood cancer survivors who are underweight are at increased risk for late mortality that appears unrelated to smoking status, recognized chronic disease, or subsequent malignancy. Whether targeted nutritional interventions would ameliorate this risk is unknown.
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