Metabolic Syndrome in Childhood Cancer Survivors

Over 200,000 children under the age of fifteen are diagnosed with cancer worldwide every year. Cancer is the second most common cause of death among children between the ages of 1 and 14 years in developed countries, surpassed only by accidents.Nearly one third of the cancers diagnosed in children are leukemias (particularly acute lymphoblastic leukemia (ALL)), followed by cancer of the brain or central nervous system (21%), soft tissue sarcomas (including neuroblastoma (7%) and rhabdomyosarcoma (3%)), renal (nephroblastoma) tumors (5%), and non-Hodgkin lymphoma (4%). Childhood cancer survival has increased significantly over the past few decades (Figure 1). Especially the advent of combination chemotherapy in the late 1960s and 1970s brought about large increases in survival for many childhood cancers. Furthermore, improved surgery, radiotherapy, stem cell transplantation, supportive care and better stratification of therapy regimens played an important role. Population-based statistics show the probability of fiveyear survival of cancer in those under the age of 20 in the United States to be 80%. This success in therapy translates into a growing and aging population of long-term survivors. To date, 1 out of 640 young adults in the United States is a childhood cancer survivor. In the Netherlands, currently 7000 adults are long-term childhood cancer survivors.

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