Metabolic syndrome in childhood, adolescent, and young adult cancer survivors: recommendations for surveillance from the International Late Effects of Childhood Cancer Guideline Harmonization Group
(2025) In European Journal of Endocrinology 192(4). p.27-40- 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... (More)
- 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. © 2025 The Author(s). Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved. (Less)
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- author
- van den Oever, S.R. ; Giwercman, A. LU and Tonorezos, E.
- author collaboration
- organization
- publishing date
- 2025
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- long-term follow-up care, metabolic syndrome, pediatric oncology, survivorship, Adolescent, Adult, Cancer Survivors, Child, Humans, Metabolic Syndrome, Neoplasms, Population Surveillance, Practice Guidelines as Topic, Young Adult, adolescent, adult, cancer survivor, child, complication, diagnosis, epidemiology, etiology, human, metabolic syndrome X, neoplasm, population surveillance, practice guideline, procedures, therapy, young adult
- in
- European Journal of Endocrinology
- volume
- 192
- issue
- 4
- pages
- 27 - 40
- publisher
- Society of the European Journal of Endocrinology
- external identifiers
-
- scopus:105002796361
- pmid:40103414
- ISSN
- 0804-4643
- DOI
- 10.1093/ejendo/lvaf046
- language
- English
- LU publication?
- yes
- id
- 16bfa3c3-6280-4145-93a0-7c4d0f3e081e
- date added to LUP
- 2025-12-18 11:04:39
- date last changed
- 2025-12-19 03:00:08
@article{16bfa3c3-6280-4145-93a0-7c4d0f3e081e,
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. © 2025 The Author(s). Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved.}},
author = {{van den Oever, S.R. and Giwercman, A. and Tonorezos, E.}},
issn = {{0804-4643}},
keywords = {{long-term follow-up care; metabolic syndrome; pediatric oncology; survivorship; Adolescent; Adult; Cancer Survivors; Child; Humans; Metabolic Syndrome; Neoplasms; Population Surveillance; Practice Guidelines as Topic; Young Adult; adolescent; adult; cancer survivor; child; complication; diagnosis; epidemiology; etiology; human; metabolic syndrome X; neoplasm; population surveillance; practice guideline; procedures; therapy; young adult}},
language = {{eng}},
number = {{4}},
pages = {{27--40}},
publisher = {{Society of the European Journal of Endocrinology}},
series = {{European Journal of Endocrinology}},
title = {{Metabolic syndrome in childhood, adolescent, and young adult cancer survivors: recommendations for surveillance from the International Late Effects of Childhood Cancer Guideline Harmonization Group}},
url = {{http://dx.doi.org/10.1093/ejendo/lvaf046}},
doi = {{10.1093/ejendo/lvaf046}},
volume = {{192}},
year = {{2025}},
}