Overview of national/multicenter childhood cancer survivor cohort studies with an outcome for diabetes mellitus
| Reference . | Design . | Country (cohort) . | Cohort size . | Definition of DM . | CCS (N=…) . | Male, % . | Age . | Follow-up . | DM, % . | Risk? . | Prognostic variable . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Noyd (2023) (38) | 3 | North-America (CCSS) | 4 | Self-report (diagnosis + antidiabetic medication use) | 1092 (NHB)/1405 (Hispanic)/13 960 (NHW) | 53.6/53.3/52.9 | M/Mdn NR | NR | 8.4/9.7/5.1a | NR | Race/ethnicity |
| Lipshultz (2022) (22) | 1 | US | 4 | Fasting glucose ≥126 mg/dL or HbA1c ≥ 6.5% | 164 | 55.5 | Mdn 28.9 y (16-38) | Mdn 17.4 y (13-22) | 2.5 | 1.6% in controls, P = .50 (NHANES)b | NR |
| Chow (2022) (16) | 2 | North America (CCSS) | 4 | Self-report (diagnosis) | 571 | 43.1 | Mdn 37.7 y (20.1-65.0) | Mdn 28.5 y (18.3-49.0) | 9.1 | 3.8% in controls, P = .002 (NHANES)b | NR |
| Friedman (2020) (17) | 3 | North America (CCSS) | 4 | Self-report (diagnosis + antidiabetic medication use) | 16 194/4 568c | 53.0/53.6 | Mdn 28.6 y (8.7-57.9)/Mdn 31.6 y (10.2-58.3) | Mdn 16.3 y (2.0-34.2)/Mdn 17.7 y (2.3-33.9) | 1.2/2.3 | RR 1.83 (95% CI, 1.29-2.60); P = .001/2.92 (2.02-4.23); P < .001 (sibling controls) | Older age, higher BMI, higher pancreatic tail radiation dose |
| Freycon (2019) (27) | 3 | France | 3 | Presence of diabetes, not further defined | 71 (HSCT + TBI) | 49.3 | Mdn 25.0 y (17.0-42.0) | Mdn 14.8 y (4.4-27.2) | 11.3 | NR | NR |
| Duncan (2018)(26) | 3 | US | 4 | Medical records (diagnosis + antidiabetic medication use) | 607 (HSCT) | 56 | Mdn 18.5 y (3.0-38.0) | Mdn 97 mo (24-230) | 7.7 | NR | NR |
| Faber (2018) (25) | 1 | Germany (CVSS) | 2 | Medical records (diagnosis/medication use) or HBA1c ≥ 6.5% | 951 | 55.3 | M 34.0 y (23-48) | M 28.4 y (23-36) | 2.0 | SPR (95% CI)d: 1.00 (0.39-1.89) (GHS, 35-48y); 0.95 (0.51-1.61) (DEGS); 2.00 (1.08-3.67) (KORA) | NR |
| Winther (2018) (18) | 3 | 5 Nordic countries (ALiCCS) | 1 | Hospital contacts | 29 324 | NR | NR | NR | 1.1 | HR 1.7 (95% CI, 1.5-1.9) (population comparison participants) | NR |
| Lega (2018) (19) | 3 | Canada | 3 | Health databases (diagnosis) | 10 438 | 53.1 | NR | M 11.2 y ± 6.9 | 1.5 | HR 1.51 (95% CI, 1.28-1.78) (age- and sex-matched controls, adjusted for rurality and income) | NR |
| Mostoufi-Moab (2016) (20) | 3 | North America (CCSS) | 4 | Self-report (antidiabetic medication use) | 14 290 | 54 | M 32 y (5-58) | Mdn 24 y (5-39) | 0.5-3.8 | RR 1.8 (95% CI, 1.4-2.3) (sibling controls) | TBI and Abd RT |
| Kero (2016) (7) | 3 | Finland | 2 | Purchase of antidiabetic medication | 2530 | 52.9 | Mdn 19.2 y (0-37.0) | Mdn 10.4 y (0-18) | 2.1 | HR 3.0 (95% CI, 1.5-6.1) (sibling controls) | Tumor type: ALL, AML, CNS, HL |
| Chao (2016) (23) | 3 | US | 4 | Health databases (diagnosis) | 652 | 53.2 | NR | M 6.2 y ± 4.1 | 1.1 | IRR 1.6 (95% CI, 0.7-3.7) (age- and sex-matched controls, adjusted for race) | NR |
| Holmqvist (2014) (6) | 3 | 5 Nordic countries (ALiCCS) | 1 | Hospital contacts | 32 903 | 53.4 | NR | Mdn 10 y (0-42) | 1.5 | SHRR 1.6 (95% CI, 1.5-1.8) and AER 43 (32-53) (age-, sex-, country-matched controls) | Tumor type: WT, leukemia, CNS, germ-cell, malignant bone, HL |
| Patterson (2012) (39) | 3 | US | 4 | Medical records (diagnosis) | 519 (CNS) | 51.2 | M 12.1 y ± 4.4 | M 7.2 y ± 3.7 | 0.4 | NR | NR |
| de Vathaire (2012) (24) | 3 | France and UK | 4 | Self-report, confirmed by medical records | 2520 | 53.3 | NR | Mdn 28 y (IQR 24-35) | 2.6 | NR | Pancreatic tail radiation |
| Meacham (2009) (21) | 2 | North-America (CCSS) | 4 | Self-report (antidiabetic medication use) | 8599 | 51.5 | M 31.5 y (17.0-54.1) | M 23.5 y (16.0-35.2) | 2.5 | OR 1.8 (95% CI, 1.3-2.5) (sibling controls, adjusted for age, sex, race/ethnicity, household income, health insurance, and BMI) | TBI, abd RT, alkylating agents, younger age at Dx, older attained age, higher BMI |
| Reference . | Design . | Country (cohort) . | Cohort size . | Definition of DM . | CCS (N=…) . | Male, % . | Age . | Follow-up . | DM, % . | Risk? . | Prognostic variable . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Noyd (2023) (38) | 3 | North-America (CCSS) | 4 | Self-report (diagnosis + antidiabetic medication use) | 1092 (NHB)/1405 (Hispanic)/13 960 (NHW) | 53.6/53.3/52.9 | M/Mdn NR | NR | 8.4/9.7/5.1a | NR | Race/ethnicity |
| Lipshultz (2022) (22) | 1 | US | 4 | Fasting glucose ≥126 mg/dL or HbA1c ≥ 6.5% | 164 | 55.5 | Mdn 28.9 y (16-38) | Mdn 17.4 y (13-22) | 2.5 | 1.6% in controls, P = .50 (NHANES)b | NR |
| Chow (2022) (16) | 2 | North America (CCSS) | 4 | Self-report (diagnosis) | 571 | 43.1 | Mdn 37.7 y (20.1-65.0) | Mdn 28.5 y (18.3-49.0) | 9.1 | 3.8% in controls, P = .002 (NHANES)b | NR |
| Friedman (2020) (17) | 3 | North America (CCSS) | 4 | Self-report (diagnosis + antidiabetic medication use) | 16 194/4 568c | 53.0/53.6 | Mdn 28.6 y (8.7-57.9)/Mdn 31.6 y (10.2-58.3) | Mdn 16.3 y (2.0-34.2)/Mdn 17.7 y (2.3-33.9) | 1.2/2.3 | RR 1.83 (95% CI, 1.29-2.60); P = .001/2.92 (2.02-4.23); P < .001 (sibling controls) | Older age, higher BMI, higher pancreatic tail radiation dose |
| Freycon (2019) (27) | 3 | France | 3 | Presence of diabetes, not further defined | 71 (HSCT + TBI) | 49.3 | Mdn 25.0 y (17.0-42.0) | Mdn 14.8 y (4.4-27.2) | 11.3 | NR | NR |
| Duncan (2018)(26) | 3 | US | 4 | Medical records (diagnosis + antidiabetic medication use) | 607 (HSCT) | 56 | Mdn 18.5 y (3.0-38.0) | Mdn 97 mo (24-230) | 7.7 | NR | NR |
| Faber (2018) (25) | 1 | Germany (CVSS) | 2 | Medical records (diagnosis/medication use) or HBA1c ≥ 6.5% | 951 | 55.3 | M 34.0 y (23-48) | M 28.4 y (23-36) | 2.0 | SPR (95% CI)d: 1.00 (0.39-1.89) (GHS, 35-48y); 0.95 (0.51-1.61) (DEGS); 2.00 (1.08-3.67) (KORA) | NR |
| Winther (2018) (18) | 3 | 5 Nordic countries (ALiCCS) | 1 | Hospital contacts | 29 324 | NR | NR | NR | 1.1 | HR 1.7 (95% CI, 1.5-1.9) (population comparison participants) | NR |
| Lega (2018) (19) | 3 | Canada | 3 | Health databases (diagnosis) | 10 438 | 53.1 | NR | M 11.2 y ± 6.9 | 1.5 | HR 1.51 (95% CI, 1.28-1.78) (age- and sex-matched controls, adjusted for rurality and income) | NR |
| Mostoufi-Moab (2016) (20) | 3 | North America (CCSS) | 4 | Self-report (antidiabetic medication use) | 14 290 | 54 | M 32 y (5-58) | Mdn 24 y (5-39) | 0.5-3.8 | RR 1.8 (95% CI, 1.4-2.3) (sibling controls) | TBI and Abd RT |
| Kero (2016) (7) | 3 | Finland | 2 | Purchase of antidiabetic medication | 2530 | 52.9 | Mdn 19.2 y (0-37.0) | Mdn 10.4 y (0-18) | 2.1 | HR 3.0 (95% CI, 1.5-6.1) (sibling controls) | Tumor type: ALL, AML, CNS, HL |
| Chao (2016) (23) | 3 | US | 4 | Health databases (diagnosis) | 652 | 53.2 | NR | M 6.2 y ± 4.1 | 1.1 | IRR 1.6 (95% CI, 0.7-3.7) (age- and sex-matched controls, adjusted for race) | NR |
| Holmqvist (2014) (6) | 3 | 5 Nordic countries (ALiCCS) | 1 | Hospital contacts | 32 903 | 53.4 | NR | Mdn 10 y (0-42) | 1.5 | SHRR 1.6 (95% CI, 1.5-1.8) and AER 43 (32-53) (age-, sex-, country-matched controls) | Tumor type: WT, leukemia, CNS, germ-cell, malignant bone, HL |
| Patterson (2012) (39) | 3 | US | 4 | Medical records (diagnosis) | 519 (CNS) | 51.2 | M 12.1 y ± 4.4 | M 7.2 y ± 3.7 | 0.4 | NR | NR |
| de Vathaire (2012) (24) | 3 | France and UK | 4 | Self-report, confirmed by medical records | 2520 | 53.3 | NR | Mdn 28 y (IQR 24-35) | 2.6 | NR | Pancreatic tail radiation |
| Meacham (2009) (21) | 2 | North-America (CCSS) | 4 | Self-report (antidiabetic medication use) | 8599 | 51.5 | M 31.5 y (17.0-54.1) | M 23.5 y (16.0-35.2) | 2.5 | OR 1.8 (95% CI, 1.3-2.5) (sibling controls, adjusted for age, sex, race/ethnicity, household income, health insurance, and BMI) | TBI, abd RT, alkylating agents, younger age at Dx, older attained age, higher BMI |
This table shows an overview of available national/multicenter based studies on diabetes mellitus in childhood cancer survivors. The literature search and search flowchart are depicted in Supplementary Table S6 and Supplementary Fig. S2, respectively. The overview of available single-center studies is depicted in Supplementary Table S7. Holmqvist (2014) and Winther (2018) describe the same cohort but with different risk calculations. The study by Meacham (2010) is not included in the table since it reports on the same cohort as Meacham (2009) with similar results and calculations. Age and follow-up time are shown as mean (M) ±SD or (range)/median (Mdn) (range).
Study design: 1 = prospective study, 2 = cross-sectional study, 3 = retrospective study.
Cohort size: 1 = nationwide (>1 country), 2 = nationwide (=1 country), 3 = population-based, 4 = multicenter.
Abbreviations: abd, abdominal; AER, absolute excess risk; AFR, African ancestry; ALiCCS, Adult Life After Childhood Cancer in Scandinavia; ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; BMI, body mass index; CCS, childhood cancer survivor; CCSS, Childhood Cancer Survivor Study; CCSS, Childhood Cancer Survivor Study; CNS, central nervous system; CTCAE, Common Terminology Criteria for Adverse Events; CVSS, cardiac and vascular late sequelae in long-term survivors of childhood cancer study; DEGS, German Health Interview and Examination Survey for Adults; DM, diabetes mellitus; Dx, diagnosis; EUR, European ancestry; GHS, Gutenberg Health Study; HbA1c, glycated hemoglobin A1c; HL, Hodgkin lymphoma; HR, hazard ratio; HSCT, hematopoietic stem cell transplantation; IQR, interquartile range; IRR, incidence rate ratio; KORA, Cooperative Health Research in the region of Augsburg; M, mean; Mdn, median; NHANES, National Health and Nutrition Examination Survey; NHB, non-Hispanic Black; NHW, non-Hispanic white; NR, not reported; OR, odds ratio; RR, relative risk; RT, radiotherapy; SHRR, standardized hospitalization rate ratio; SJLIFE, St. Jude Lifetime Study Cohort; SPR, standardized prevalence ratio; TBI, total body irradiation; UK, United Kingdom; US, United States; WT, Wilms tumor.
aCumulative incidence by age 40 years.
bNHANES included in these depicted studies are age-, sex-, and race-matched controls from the NHANES database as controls.
cFirst number depicted is for CCS with no exposure to abdominal irradiation, the second number depicted is regarding CCS with exposure to abd irradiation.
dThis study used 3 different population cohort studies as controls (name in parentheses and in abbreviations).
Overview of national/multicenter childhood cancer survivor cohort studies with an outcome for diabetes mellitus
| Reference . | Design . | Country (cohort) . | Cohort size . | Definition of DM . | CCS (N=…) . | Male, % . | Age . | Follow-up . | DM, % . | Risk? . | Prognostic variable . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Noyd (2023) (38) | 3 | North-America (CCSS) | 4 | Self-report (diagnosis + antidiabetic medication use) | 1092 (NHB)/1405 (Hispanic)/13 960 (NHW) | 53.6/53.3/52.9 | M/Mdn NR | NR | 8.4/9.7/5.1a | NR | Race/ethnicity |
| Lipshultz (2022) (22) | 1 | US | 4 | Fasting glucose ≥126 mg/dL or HbA1c ≥ 6.5% | 164 | 55.5 | Mdn 28.9 y (16-38) | Mdn 17.4 y (13-22) | 2.5 | 1.6% in controls, P = .50 (NHANES)b | NR |
| Chow (2022) (16) | 2 | North America (CCSS) | 4 | Self-report (diagnosis) | 571 | 43.1 | Mdn 37.7 y (20.1-65.0) | Mdn 28.5 y (18.3-49.0) | 9.1 | 3.8% in controls, P = .002 (NHANES)b | NR |
| Friedman (2020) (17) | 3 | North America (CCSS) | 4 | Self-report (diagnosis + antidiabetic medication use) | 16 194/4 568c | 53.0/53.6 | Mdn 28.6 y (8.7-57.9)/Mdn 31.6 y (10.2-58.3) | Mdn 16.3 y (2.0-34.2)/Mdn 17.7 y (2.3-33.9) | 1.2/2.3 | RR 1.83 (95% CI, 1.29-2.60); P = .001/2.92 (2.02-4.23); P < .001 (sibling controls) | Older age, higher BMI, higher pancreatic tail radiation dose |
| Freycon (2019) (27) | 3 | France | 3 | Presence of diabetes, not further defined | 71 (HSCT + TBI) | 49.3 | Mdn 25.0 y (17.0-42.0) | Mdn 14.8 y (4.4-27.2) | 11.3 | NR | NR |
| Duncan (2018)(26) | 3 | US | 4 | Medical records (diagnosis + antidiabetic medication use) | 607 (HSCT) | 56 | Mdn 18.5 y (3.0-38.0) | Mdn 97 mo (24-230) | 7.7 | NR | NR |
| Faber (2018) (25) | 1 | Germany (CVSS) | 2 | Medical records (diagnosis/medication use) or HBA1c ≥ 6.5% | 951 | 55.3 | M 34.0 y (23-48) | M 28.4 y (23-36) | 2.0 | SPR (95% CI)d: 1.00 (0.39-1.89) (GHS, 35-48y); 0.95 (0.51-1.61) (DEGS); 2.00 (1.08-3.67) (KORA) | NR |
| Winther (2018) (18) | 3 | 5 Nordic countries (ALiCCS) | 1 | Hospital contacts | 29 324 | NR | NR | NR | 1.1 | HR 1.7 (95% CI, 1.5-1.9) (population comparison participants) | NR |
| Lega (2018) (19) | 3 | Canada | 3 | Health databases (diagnosis) | 10 438 | 53.1 | NR | M 11.2 y ± 6.9 | 1.5 | HR 1.51 (95% CI, 1.28-1.78) (age- and sex-matched controls, adjusted for rurality and income) | NR |
| Mostoufi-Moab (2016) (20) | 3 | North America (CCSS) | 4 | Self-report (antidiabetic medication use) | 14 290 | 54 | M 32 y (5-58) | Mdn 24 y (5-39) | 0.5-3.8 | RR 1.8 (95% CI, 1.4-2.3) (sibling controls) | TBI and Abd RT |
| Kero (2016) (7) | 3 | Finland | 2 | Purchase of antidiabetic medication | 2530 | 52.9 | Mdn 19.2 y (0-37.0) | Mdn 10.4 y (0-18) | 2.1 | HR 3.0 (95% CI, 1.5-6.1) (sibling controls) | Tumor type: ALL, AML, CNS, HL |
| Chao (2016) (23) | 3 | US | 4 | Health databases (diagnosis) | 652 | 53.2 | NR | M 6.2 y ± 4.1 | 1.1 | IRR 1.6 (95% CI, 0.7-3.7) (age- and sex-matched controls, adjusted for race) | NR |
| Holmqvist (2014) (6) | 3 | 5 Nordic countries (ALiCCS) | 1 | Hospital contacts | 32 903 | 53.4 | NR | Mdn 10 y (0-42) | 1.5 | SHRR 1.6 (95% CI, 1.5-1.8) and AER 43 (32-53) (age-, sex-, country-matched controls) | Tumor type: WT, leukemia, CNS, germ-cell, malignant bone, HL |
| Patterson (2012) (39) | 3 | US | 4 | Medical records (diagnosis) | 519 (CNS) | 51.2 | M 12.1 y ± 4.4 | M 7.2 y ± 3.7 | 0.4 | NR | NR |
| de Vathaire (2012) (24) | 3 | France and UK | 4 | Self-report, confirmed by medical records | 2520 | 53.3 | NR | Mdn 28 y (IQR 24-35) | 2.6 | NR | Pancreatic tail radiation |
| Meacham (2009) (21) | 2 | North-America (CCSS) | 4 | Self-report (antidiabetic medication use) | 8599 | 51.5 | M 31.5 y (17.0-54.1) | M 23.5 y (16.0-35.2) | 2.5 | OR 1.8 (95% CI, 1.3-2.5) (sibling controls, adjusted for age, sex, race/ethnicity, household income, health insurance, and BMI) | TBI, abd RT, alkylating agents, younger age at Dx, older attained age, higher BMI |
| Reference . | Design . | Country (cohort) . | Cohort size . | Definition of DM . | CCS (N=…) . | Male, % . | Age . | Follow-up . | DM, % . | Risk? . | Prognostic variable . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Noyd (2023) (38) | 3 | North-America (CCSS) | 4 | Self-report (diagnosis + antidiabetic medication use) | 1092 (NHB)/1405 (Hispanic)/13 960 (NHW) | 53.6/53.3/52.9 | M/Mdn NR | NR | 8.4/9.7/5.1a | NR | Race/ethnicity |
| Lipshultz (2022) (22) | 1 | US | 4 | Fasting glucose ≥126 mg/dL or HbA1c ≥ 6.5% | 164 | 55.5 | Mdn 28.9 y (16-38) | Mdn 17.4 y (13-22) | 2.5 | 1.6% in controls, P = .50 (NHANES)b | NR |
| Chow (2022) (16) | 2 | North America (CCSS) | 4 | Self-report (diagnosis) | 571 | 43.1 | Mdn 37.7 y (20.1-65.0) | Mdn 28.5 y (18.3-49.0) | 9.1 | 3.8% in controls, P = .002 (NHANES)b | NR |
| Friedman (2020) (17) | 3 | North America (CCSS) | 4 | Self-report (diagnosis + antidiabetic medication use) | 16 194/4 568c | 53.0/53.6 | Mdn 28.6 y (8.7-57.9)/Mdn 31.6 y (10.2-58.3) | Mdn 16.3 y (2.0-34.2)/Mdn 17.7 y (2.3-33.9) | 1.2/2.3 | RR 1.83 (95% CI, 1.29-2.60); P = .001/2.92 (2.02-4.23); P < .001 (sibling controls) | Older age, higher BMI, higher pancreatic tail radiation dose |
| Freycon (2019) (27) | 3 | France | 3 | Presence of diabetes, not further defined | 71 (HSCT + TBI) | 49.3 | Mdn 25.0 y (17.0-42.0) | Mdn 14.8 y (4.4-27.2) | 11.3 | NR | NR |
| Duncan (2018)(26) | 3 | US | 4 | Medical records (diagnosis + antidiabetic medication use) | 607 (HSCT) | 56 | Mdn 18.5 y (3.0-38.0) | Mdn 97 mo (24-230) | 7.7 | NR | NR |
| Faber (2018) (25) | 1 | Germany (CVSS) | 2 | Medical records (diagnosis/medication use) or HBA1c ≥ 6.5% | 951 | 55.3 | M 34.0 y (23-48) | M 28.4 y (23-36) | 2.0 | SPR (95% CI)d: 1.00 (0.39-1.89) (GHS, 35-48y); 0.95 (0.51-1.61) (DEGS); 2.00 (1.08-3.67) (KORA) | NR |
| Winther (2018) (18) | 3 | 5 Nordic countries (ALiCCS) | 1 | Hospital contacts | 29 324 | NR | NR | NR | 1.1 | HR 1.7 (95% CI, 1.5-1.9) (population comparison participants) | NR |
| Lega (2018) (19) | 3 | Canada | 3 | Health databases (diagnosis) | 10 438 | 53.1 | NR | M 11.2 y ± 6.9 | 1.5 | HR 1.51 (95% CI, 1.28-1.78) (age- and sex-matched controls, adjusted for rurality and income) | NR |
| Mostoufi-Moab (2016) (20) | 3 | North America (CCSS) | 4 | Self-report (antidiabetic medication use) | 14 290 | 54 | M 32 y (5-58) | Mdn 24 y (5-39) | 0.5-3.8 | RR 1.8 (95% CI, 1.4-2.3) (sibling controls) | TBI and Abd RT |
| Kero (2016) (7) | 3 | Finland | 2 | Purchase of antidiabetic medication | 2530 | 52.9 | Mdn 19.2 y (0-37.0) | Mdn 10.4 y (0-18) | 2.1 | HR 3.0 (95% CI, 1.5-6.1) (sibling controls) | Tumor type: ALL, AML, CNS, HL |
| Chao (2016) (23) | 3 | US | 4 | Health databases (diagnosis) | 652 | 53.2 | NR | M 6.2 y ± 4.1 | 1.1 | IRR 1.6 (95% CI, 0.7-3.7) (age- and sex-matched controls, adjusted for race) | NR |
| Holmqvist (2014) (6) | 3 | 5 Nordic countries (ALiCCS) | 1 | Hospital contacts | 32 903 | 53.4 | NR | Mdn 10 y (0-42) | 1.5 | SHRR 1.6 (95% CI, 1.5-1.8) and AER 43 (32-53) (age-, sex-, country-matched controls) | Tumor type: WT, leukemia, CNS, germ-cell, malignant bone, HL |
| Patterson (2012) (39) | 3 | US | 4 | Medical records (diagnosis) | 519 (CNS) | 51.2 | M 12.1 y ± 4.4 | M 7.2 y ± 3.7 | 0.4 | NR | NR |
| de Vathaire (2012) (24) | 3 | France and UK | 4 | Self-report, confirmed by medical records | 2520 | 53.3 | NR | Mdn 28 y (IQR 24-35) | 2.6 | NR | Pancreatic tail radiation |
| Meacham (2009) (21) | 2 | North-America (CCSS) | 4 | Self-report (antidiabetic medication use) | 8599 | 51.5 | M 31.5 y (17.0-54.1) | M 23.5 y (16.0-35.2) | 2.5 | OR 1.8 (95% CI, 1.3-2.5) (sibling controls, adjusted for age, sex, race/ethnicity, household income, health insurance, and BMI) | TBI, abd RT, alkylating agents, younger age at Dx, older attained age, higher BMI |
This table shows an overview of available national/multicenter based studies on diabetes mellitus in childhood cancer survivors. The literature search and search flowchart are depicted in Supplementary Table S6 and Supplementary Fig. S2, respectively. The overview of available single-center studies is depicted in Supplementary Table S7. Holmqvist (2014) and Winther (2018) describe the same cohort but with different risk calculations. The study by Meacham (2010) is not included in the table since it reports on the same cohort as Meacham (2009) with similar results and calculations. Age and follow-up time are shown as mean (M) ±SD or (range)/median (Mdn) (range).
Study design: 1 = prospective study, 2 = cross-sectional study, 3 = retrospective study.
Cohort size: 1 = nationwide (>1 country), 2 = nationwide (=1 country), 3 = population-based, 4 = multicenter.
Abbreviations: abd, abdominal; AER, absolute excess risk; AFR, African ancestry; ALiCCS, Adult Life After Childhood Cancer in Scandinavia; ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; BMI, body mass index; CCS, childhood cancer survivor; CCSS, Childhood Cancer Survivor Study; CCSS, Childhood Cancer Survivor Study; CNS, central nervous system; CTCAE, Common Terminology Criteria for Adverse Events; CVSS, cardiac and vascular late sequelae in long-term survivors of childhood cancer study; DEGS, German Health Interview and Examination Survey for Adults; DM, diabetes mellitus; Dx, diagnosis; EUR, European ancestry; GHS, Gutenberg Health Study; HbA1c, glycated hemoglobin A1c; HL, Hodgkin lymphoma; HR, hazard ratio; HSCT, hematopoietic stem cell transplantation; IQR, interquartile range; IRR, incidence rate ratio; KORA, Cooperative Health Research in the region of Augsburg; M, mean; Mdn, median; NHANES, National Health and Nutrition Examination Survey; NHB, non-Hispanic Black; NHW, non-Hispanic white; NR, not reported; OR, odds ratio; RR, relative risk; RT, radiotherapy; SHRR, standardized hospitalization rate ratio; SJLIFE, St. Jude Lifetime Study Cohort; SPR, standardized prevalence ratio; TBI, total body irradiation; UK, United Kingdom; US, United States; WT, Wilms tumor.
aCumulative incidence by age 40 years.
bNHANES included in these depicted studies are age-, sex-, and race-matched controls from the NHANES database as controls.
cFirst number depicted is for CCS with no exposure to abdominal irradiation, the second number depicted is regarding CCS with exposure to abd irradiation.
dThis study used 3 different population cohort studies as controls (name in parentheses and in abbreviations).
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