Abstract

Background: In the general population, dyslipidemia impacts 36% of adults between the ages of 20 and 29 years. Among survivors of childhood, adolescent, and young adult-onset cancer (C-AYAs), the prevalence of dyslipidemia in racially diverse cohorts as well as our understanding of which measured fats are most commonly abnormal are limited. Question: Among a diverse group of C-AYAs, what is the prevalence of dyslipidemia and which fats are most contributory? Methods: Individuals diagnosed with cancer at age ≤39 years and treated with anthracycline based chemotherapy between 2010-2022 were identified. Depending on age at time of collection, post-treatment lipid panels were analyzed according to AAP (<20 years) or ACC/AHA (≥20 years) guidelines. Non-fasting panels were included, in accordance with ACC/AHA guidelines. The prevalence of dyslipidemia and median values for measured fats were determined. Non-parametric testing was used to examine associations between dyslipidemia, age, and race. Results: Among a diverse (40% Black, 52% White) cohort of C-AYAs (227 total) with a median current age of 25 years (interquartile range (IQR) 20-36 years) and median total doxorubicin isotoxic equivalents of 200mg/m 2 (IQR 120-300 mg/m 2 ), the prevalence of dyslipidemia was 55%. Prevalence of dyslipidemia was not associated with race (Black 55%, White 64%, Other 44%, p=0.281) or age (<20 years 51%, ≥20 years 64%, p = 0.055). Among Black and White subjects, HDL was most commonly abnormal (Black 42%, White 38%), followed by triglycerides (TG) (Black 29%, White 41%). Median TG levels were significantly lower among Black individuals ≥20 years compared with White individuals (117 mg/dL vs 143 mg/dL, p = 0.030). Conclusions: Among a diverse group of C-AYAs, dyslipidemia was highly prevalent even at a younger age (<20 years). Race was not associated with prevalence of dyslipidemia. Dyslipidemia was primarily driven by HDL and TG abnormalities, fats associated with metabolic syndrome.

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