Metabolic syndrome in childhood, adolescent, and young adult cancer survivors: recommendations for surveillance from the International Late Effects of Childhood Cancer Guideline Harmonization Group.
Document Type
Article
Publication Date
3-27-2025
Identifier
DOI: 10.1093/ejendo/lvaf046
Abstract
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, (pre)diabetes, and dyslipidaemia. While associated cardiovascular sequelae can be serious, MetS is preventable, manageable, and potentially reversible with the appropriate pharmacological and/or behavioral interventions. To optimize health outcomes in CAYA cancer survivors, international, harmonized 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 2 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.
Journal Title
European journal of endocrinology / European Federation of Endocrine Societies
Volume
192
Issue
4
First Page
27
Last Page
40
MeSH Keywords
Humans; Metabolic Syndrome; Cancer Survivors; Adolescent; Child; Young Adult; Neoplasms; Adult; Practice Guidelines as Topic; Population Surveillance
PubMed ID
40103414
Keywords
long-term follow-up care; metabolic syndrome; pediatric oncology; survivorship
Recommended Citation
van den Oever SR, Mulder RL, Oeffinger KC, et al. Metabolic syndrome in childhood, adolescent, and young adult cancer survivors: recommendations for surveillance from the International Late Effects of Childhood Cancer Guideline Harmonization Group. Eur J Endocrinol. 2025;192(4):S27-S40. doi:10.1093/ejendo/lvaf046