Obesity, Inadequate Physical Activity Increase Subsequent Neoplasm Risk in Childhood Cancer Survivors – Oncology Nurse Advisor

Report on the Association Between Obesity, Physical Activity, and Subsequent Neoplasm Risk in Childhood Cancer Survivors

Introduction

A recent study published in JAMA Oncology highlights the significant association between obesity and increased risk of multiple subsequent neoplasms in childhood cancer survivors. This research aligns with the Sustainable Development Goals (SDGs), particularly SDG 3: Good Health and Well-being, by emphasizing the importance of preventive health measures in vulnerable populations.

Background

• Previous studies have identified high body mass index (BMI) and inadequate physical activity as risk factors for adult-onset cancers.
• Data on childhood cancer survivors regarding these risk factors have been limited.

Study Design and Population

1. Retrospective study conducted by Dr. Lenat Joffe and colleagues at Northwell, New Hyde Park, New York.
2. Included 5-year survivors of childhood cancer diagnosed before age 21 between 1970 and 1999.
3. Participants were enrolled in the Childhood Cancer Survivor Study (CCSS) with follow-up data through September 2019.
4. A total of 22,716 patients had BMI data available; among them, 2,156 developed 2,554 subsequent neoplasms.

Key Findings

• Obesity was associated with an increased risk of multiple types of subsequent neoplasms.
• Higher physical activity levels were linked to a reduced risk of subsequent neoplasms.
• Lower physical activity (0 MET-hour/week) corresponded to a 30-year cumulative neoplasm incidence of 18.6%, compared to 10.9% in those with higher activity (15-21 MET-hour/week).
• Obese survivors showed higher incidence rates of subsequent neoplasms in:
  • Solid organs (Relative Risk [RR] 1.22)
  • Central nervous system (RR 1.47)
  • Skin (RR 1.30)
• Higher physical activity demonstrated protective effects against these neoplasms.
• No significant association was found between BMI/physical activity and breast cancer, colorectal cancer, or hematologic neoplasms.

Implications for Sustainable Development Goals (SDGs)

• SDG 3: Good Health and Well-being – The study underscores the critical role of maintaining healthy BMI and physical activity to reduce cancer risks among childhood cancer survivors.
• SDG 10: Reduced Inequalities – Addressing obesity and physical inactivity in this vulnerable group can help reduce health disparities.
• SDG 4: Quality Education – Promoting awareness and education about lifestyle factors in cancer survivorship is essential.

Conclusion

The study concludes that obesity significantly increases the risk for various subsequent neoplasms in childhood cancer survivors, whereas higher physical activity levels are protective. These findings advocate for targeted interventions to promote healthy lifestyles among survivors, contributing to the achievement of global health and well-being goals.

Reference

Joffe L, Mirzaei S, Bhatia S, et al. Body mass index, physical activity, and subsequent neoplasm risk among childhood cancer survivors. JAMA Oncol. 2025:e251340. doi:10.1001/jamaoncol.2025.1340

1. Sustainable Development Goals (SDGs) Addressed or Connected to the Issues Highlighted in the Article

1. SDG 3: Good Health and Well-being
   • The article focuses on health outcomes related to obesity, physical activity, and cancer risks among childhood cancer survivors.
   • It addresses the prevention and reduction of non-communicable diseases (NCDs), including cancer.
2. SDG 2: Zero Hunger
   • Indirectly connected through the focus on body mass index (BMI) and nutrition, which are related to food security and healthy diets.
3. SDG 4: Quality Education
   • Implied through the importance of awareness and education on physical activity and healthy lifestyles for childhood cancer survivors.

2. Specific Targets Under Those SDGs Identified Based on the Article’s Content

1. SDG 3: Good Health and Well-being
   • Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
   • Target 3.8: Achieve universal health coverage, including access to quality essential health-care services.
   • Target 3.b: Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries.
2. SDG 2: Zero Hunger
   • Target 2.2: By 2030, end all forms of malnutrition, including achieving the internationally agreed targets on stunted and wasted children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women, and older persons.
3. SDG 4: Quality Education
   • Target 4.7: By 2030, ensure that all learners acquire the knowledge and skills needed to promote sustainable development, including health and well-being.

3. Indicators Mentioned or Implied in the Article to Measure Progress Towards the Identified Targets

1. Body Mass Index (BMI) Levels
   • Used to measure obesity prevalence among childhood cancer survivors, indicating risk factors for subsequent neoplasms.
2. Physical Activity Levels (MET-hour/week)
   • Measured as metabolic equivalent of task (MET)-hours per week to assess engagement in physical activity and its protective effect against neoplasm risk.
3. Incidence of Subsequent Neoplasms
   • Cumulative incidence rates of various types of subsequent neoplasms (solid organs, central nervous system, skin) among survivors.
   • Relative risk (RR) values for neoplasm types associated with obesity and physical activity.
4. Survivorship Duration
   • Follow-up period (up to 30 years) to track long-term health outcomes in childhood cancer survivors.

4. Table: SDGs, Targets and Indicators

Source: oncologynurseadvisor.com