Cardiometabolic Risk and Awareness of Anthracycline-Related Cardiotoxicity in Survivors of Childhood Cancer: A Population-Based Study.
Anthracycline chemotherapy is associated with cardiotoxicity, underscoring the importance of minimizing modifiable cardiac risk factors in affected individuals. This study evaluated cardiac function, prevalence of metabolic syndrome and smoking, and awareness of prior cardiotoxic treatment among adult survivors of childhood cancer treated with anthracyclines at the pediatric oncology service in Iceland between 1981 and 2011 (n=89). Data were collected from medical records, self-reported questionnaires, and clinical assessments conducted between 2016 and 2019. Of 76 eligible survivors, 60 participated (29 females, 31 males; aged 20 to 48 y). Two individuals were excluded before enrollment due to previously diagnosed heart failure. Left ventricular dilation was observed in 15 participants (25%), predominantly mild to moderate, with 1 severe case. The prevalence was lower after BSA indexing. Metabolic syndrome was present in 20% of participants, and 20% reported current smoking. Approximately half of the participants reported undergoing echocardiography within the past 10 years, while only 10% were aware that their cancer treatment could cause cardiotoxicity. These findings suggest that survivors treated with anthracyclines require systematic surveillance and targeted interventions to address modifiable cardiovascular risk factors. Increasing awareness of prior cardiotoxic cancer treatment among survivors and health care providers may facilitate cardiovascular risk reduction.