Childhood cancer survivors with premature ovarian insufficiency have low bone mineral density at long term follow-up
(2026) In Bone- Abstract
BACKGROUND: Childhood cancer survivors (CCS) are reported to have decreased bone mineral density (BMD).
PURPOSE: Is premature ovarian insufficiency (POI) an important risk factor for low BMD in CCS at long term follow-up?
PATIENTS AND METHODS: Altogether 167 female CCS, median age 34 (19-57) years, treated for childhood cancer under age 18 years between 1964 and 2008, with a follow-up time of 25 (12-41) years, and 164 matched controls took part in this cross-sectional study, including blood samples, anthropometric measurements, dual-energy X-ray absorptiometry (DXA), and questionnaires.
RESULTS: CCS with primary POI (n = 22) had lower BMD in lumbar spine L1-L4 1.13 (0.79-1.39) g/cm2 compared with controls 1.20... (More)
BACKGROUND: Childhood cancer survivors (CCS) are reported to have decreased bone mineral density (BMD).
PURPOSE: Is premature ovarian insufficiency (POI) an important risk factor for low BMD in CCS at long term follow-up?
PATIENTS AND METHODS: Altogether 167 female CCS, median age 34 (19-57) years, treated for childhood cancer under age 18 years between 1964 and 2008, with a follow-up time of 25 (12-41) years, and 164 matched controls took part in this cross-sectional study, including blood samples, anthropometric measurements, dual-energy X-ray absorptiometry (DXA), and questionnaires.
RESULTS: CCS with primary POI (n = 22) had lower BMD in lumbar spine L1-L4 1.13 (0.79-1.39) g/cm2 compared with controls 1.20 (0.84-1.56) g/cm2 (p = 0.005) and lower BMD in femoral neck 0.89 (0.72-1.16) g/cm2 compared with controls 1.00 (0.69-1.48) g/cm2 (p = 0.020). CCS with primary POI had significantly reduced levels of androgens and low BMI < 20 kg/m2 (p = 0.003). Odds Ratio for a low BMD < - 1 SD in L1-L4 was increased among CCS with primary POI (2.76 (1.01-7.52)), but also after abdominal irradiation (3.42 (1.52-7.70)) and all irradiation (1.98 (1.05-3.76)).
CONCLUSIONS: Female childhood cancer survivors are at risk of low BMD and POI is an additional risk factor at long term follow-up. Besides hypogonadism and insufficient Hormone Replacement Therapy (HRT), abdominal radiotherapy, low levels of androgens and low BMI may confer to the risk.
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- author
- Netterlid, Axel LU ; Mörse, Helena LU ; Åkesson, Kristina E LU ; Giwercman, Aleksander LU ; Henic, Emir LU ; Nyström, Anna LU ; Erfurth, Eva-Marie LU ; Becker, Charlotte LU and Elfving, Maria LU
- organization
-
- Paediatrics (Lund)
- Pediatric Oncology (research group)
- Childhood Cancer Research Unit (research group)
- Orthopedics (research group)
- EpiHealth: Epidemiology for Health
- LUCC: Lund University Cancer Centre
- Reproductive medicine, Malmö (research group)
- Medicine/Emergency Medicine, Lund
- Endocrine (research group)
- Clinical Chemistry, Malmö (research group)
- publishing date
- 2026-06-16
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- Bone
- article number
- 117984
- publisher
- Elsevier
- external identifiers
-
- pmid:42302906
- scopus:105042598620
- ISSN
- 1873-2763
- DOI
- 10.1016/j.bone.2026.117984
- language
- English
- LU publication?
- yes
- id
- 5c8c6c1d-9fa2-497c-845b-d15315abba7b
- date added to LUP
- 2026-06-17 12:16:06
- date last changed
- 2026-08-13 13:30:59
@article{5c8c6c1d-9fa2-497c-845b-d15315abba7b,
abstract = {{<p>BACKGROUND: Childhood cancer survivors (CCS) are reported to have decreased bone mineral density (BMD).</p><p>PURPOSE: Is premature ovarian insufficiency (POI) an important risk factor for low BMD in CCS at long term follow-up?</p><p>PATIENTS AND METHODS: Altogether 167 female CCS, median age 34 (19-57) years, treated for childhood cancer under age 18 years between 1964 and 2008, with a follow-up time of 25 (12-41) years, and 164 matched controls took part in this cross-sectional study, including blood samples, anthropometric measurements, dual-energy X-ray absorptiometry (DXA), and questionnaires.</p><p>RESULTS: CCS with primary POI (n = 22) had lower BMD in lumbar spine L1-L4 1.13 (0.79-1.39) g/cm2 compared with controls 1.20 (0.84-1.56) g/cm2 (p = 0.005) and lower BMD in femoral neck 0.89 (0.72-1.16) g/cm2 compared with controls 1.00 (0.69-1.48) g/cm2 (p = 0.020). CCS with primary POI had significantly reduced levels of androgens and low BMI < 20 kg/m2 (p = 0.003). Odds Ratio for a low BMD < - 1 SD in L1-L4 was increased among CCS with primary POI (2.76 (1.01-7.52)), but also after abdominal irradiation (3.42 (1.52-7.70)) and all irradiation (1.98 (1.05-3.76)).</p><p>CONCLUSIONS: Female childhood cancer survivors are at risk of low BMD and POI is an additional risk factor at long term follow-up. Besides hypogonadism and insufficient Hormone Replacement Therapy (HRT), abdominal radiotherapy, low levels of androgens and low BMI may confer to the risk.</p>}},
author = {{Netterlid, Axel and Mörse, Helena and Åkesson, Kristina E and Giwercman, Aleksander and Henic, Emir and Nyström, Anna and Erfurth, Eva-Marie and Becker, Charlotte and Elfving, Maria}},
issn = {{1873-2763}},
language = {{eng}},
month = {{06}},
publisher = {{Elsevier}},
series = {{Bone}},
title = {{Childhood cancer survivors with premature ovarian insufficiency have low bone mineral density at long term follow-up}},
url = {{http://dx.doi.org/10.1016/j.bone.2026.117984}},
doi = {{10.1016/j.bone.2026.117984}},
year = {{2026}},
}