TOPLINE:

Endocrine and metabolic diseases affected 31.3% of survivors of childhood cancer in Germany, which was nearly double the rate seen in the general population. Hypothyroidism was the most common condition among survivors.

METHODOLOGY:

• Researchers in Germany assessed the prevalence of endocrine and metabolic diseases in 11,863 5-year survivors of childhood cancer (mean age, 21.1 years; mean time since cancer diagnosis, 14.6 years; 44.1% women).
• These survivors had been diagnosed with primary cancer between 1991 and 2011 and had continuous insurance coverage from 2017 to 2021.
• They were matched with 35,589 randomly selected insured individuals without a history of childhood cancer.
• Primary outcomes were frequencies of endocrine and metabolic diseases, including thyroid disorders, adrenal gland disorders, ovarian dysfunction, testicular dysfunction, disorders of puberty, diabetes, and obesity.

TAKEAWAY:

• Nearly twice as many survivors of childhood cancer had at least one endocrine or metabolic disorder compared with individuals without childhood cancer (31.3% vs 16.4%; prevalence ratio [PR], 1.9; 95% CI, 1.8-2.0).
• The frequency of having at least one endocrine or metabolic disease was higher among women than among men in the childhood cancer survivor cohort (36.9% vs 26.9%); the PR for having at least one endocrine or metabolic disease was 2.4 in men and 1.6 in women.
• Hypothyroidism was the most frequent condition, affecting 15.85% of survivors of childhood cancer.
• A highly elevated PR was observed for thyroid cancer as a subsequent neoplasm (43.5; 95% CI, 24.2-78.1) and hypopituitarism (35.0; 95% CI, 26.8-45.7).

IN PRACTICE:

"Our findings underscore the clinical relevance of increased awareness among healthcare providers regarding endocrine morbidity in CCS [childhood cancer survivors], emphasising the need for gender-specific, risk-adapted long-term follow-up strategies and the importance of early screening of these survivors from a young age," the authors wrote.

SOURCE:

This study was led by Pietro Trocchi, Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto von Guericke University, Magdeburg, Germany. It was published online on January 19, 2026, in the European Journal of Endocrinology.

LIMITATIONS:

This study included only survivors who lived until at least 2017, introducing survivor bias. Insurance data were limited to years between 2017 and 2021, allowing for the assessment of the prevalence but not the incidence of late effects. Data came from 13 statutory health insurances, excluding private insurance companies that covered about 8% of the general population.

DISCLOSURES:

This study received funding from the Innovation Fund of the Federal Joint Committee in Germany. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.