Summary: More than 45 % of long-term childhood cancer survivors (CCS) were diagnosed with osteopenia. Our data suggest that greater awareness for osteopenia is warranted in long-term CCS, especially in survivors who are older than 30 years, male, and underweight and were treated with cranial-spinal radiotherapy and/or steroids.Introduction: Osteopenia is a potential complication of childhood cancer treatment, but the magnitude of this problem in survivors is unknown. We examined (determinants of) bone mineral density (BMD) status in long-term survivors of adult childhood cancer.Methods: This retrospective single-centre cohort study included 346 subjects with the most common types of childhood cancer. Subjects had a median age at diagnosis of 7.0 years (range 0.1–16.8 years), a median age at follow-up of 24.5 years (range 18.0–47.6 years) and a median follow-up time of 16.7 years (range 5.6–39.9 years). Total body BMD (BMDTB) and BMD of the lumbar spine (BMDLS) were measured by dual X-ray absorptiometry. Osteopenia was defined as BMD standardized deviation score (SDS) below −1.Results: Survivors had a lower BMDTB and BMDLS (mean SDS −0.55; p < 0.001 and −0.30; p < 0.001, respectively) as compared to healthy peers. Osteopenia (BMDTB and/or BMDLS) was present in 45 % of the survivors. Multivariate logistic regression analyses identified age at diagnosis <12 years, age >30 years at follow-up, male gender, underweight at follow-up and treatment with cranial-spinal radiotherapy or prednisone as independent prognostic factors for osteopenia.Conclusions: This large cohort of childhood cancer survivors identified osteopenia in 45 % of CCS. This indicates that greater awareness is warranted, especially in survivors who are older than 30 years, male, have underweight and were treated with cranial-spinal radiotherapy and/or steroids.

Additional Metadata
Keywords Adult, Bone density, Childhood cancer, Late effects, Long-term survivors, Osteopenia
Persistent URL dx.doi.org/10.1007/s00198-014-2878-z, hdl.handle.net/1765/86336
Journal Osteoporosis International: with other metabolic bone diseases
Citation
Den Hoed, M, Klap, B.C, te Winkel, M.L, Pieters, R, van Waas, M, Neggers, S.J.C.M.M, … van den Heuvel-Eibrink, M.M. (2014). Bone mineral density after childhood cancer in 346 long-term adult survivors of childhood cancer. Osteoporosis International: with other metabolic bone diseases, 26(2), 521–529. doi:10.1007/s00198-014-2878-z