{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:02:14Z","timestamp":1790172134768,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100013362","name":"Swiss Cancer Research Foundation","doi-asserted-by":"publisher","award":["KFS\u20106351\u201002\u20102025\u2010R"],"award-info":[{"award-number":["KFS\u20106351\u201002\u20102025\u2010R"]}],"id":[{"id":"10.13039\/501100013362","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013362","name":"Swiss Cancer Research Foundation","doi-asserted-by":"publisher","award":["KFS\u20106069\u201002\u20102024"],"award-info":[{"award-number":["KFS\u20106069\u201002\u20102024"]}],"id":[{"id":"10.13039\/501100013362","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013362","name":"Swiss Cancer Research Foundation","doi-asserted-by":"publisher","award":["KFS\u20105027\u201002\u20102020"],"award-info":[{"award-number":["KFS\u20105027\u201002\u20102020"]}],"id":[{"id":"10.13039\/501100013362","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["10.007.011"],"award-info":[{"award-number":["10.007.011"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Higher doses of anthracyclines and heart\u2010relevant radiotherapy increase cardiovascular disease (CVD) risk. This study assessed CVD and CVD risk factors among adult childhood cancer survivors (CCSs) across cardiotoxic treatment risk groups and examined associations between lifestyle behaviors and treatment risks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We invited CCSs aged \u226518 years at study, diagnosed at ages 0\u201320, who survived \u22655 years for an assessment of anthropometry, CVD, CVD risk factors, lifestyle, and cancer history. We classified participants into three cardiotoxic treatment risk groups (no\/low risk, moderate risk, high risk) based on anthracyclines and heart\u2010relevant radiotherapy. Multinomial logistic regression assessed lifestyle differences across groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      With a median age at study of 33 years (IQR: 26\u201339; 53% male), 356 CCSs participated in this study divided into the no\/low risk (25%), moderate risk (40%), or high risk (35%) cardiotoxic treatment groups. Overall, CVD prevalence was 6% and similar across the three risk groups. Heart valve problems were rare, though more common in the high\u2010risk group (no\/low risk, 0%; moderate risk, 1%; vs. high risk, 4%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.037). CVD risk factors were present in 44% of CCSs\u2014including dyslipidemia, obesity, hypertension, and diabetes\u2014without variation across risk groups. Overall adherence to health behavior recommendations was low, with no differences in diet adherence, physical activity (PA), sedentary behavior, smoking, or alcohol consumption across cardiotoxic risk groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We found no differences in CVD, CVD risk factors, or lifestyle behaviors across cardiotoxic treatment risk groups. Health promotion that engages diet, PA, smoking cessation, and alcohol reduction should be prioritized for all CCSs regardless of cardiotoxic treatment risk levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70089","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:57:02Z","timestamp":1767776222000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lifestyle Behaviors and Cardiotoxic Treatment Risks in Adult Childhood Cancer Survivors"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2621-1969","authenticated-orcid":false,"given":"Ruijie","family":"Li","sequence":"first","affiliation":[{"name":"Children's Health and Exercise Research Centre (CHERC) Public Health and Sport Sciences Faculty of Health and Life Sciences University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5534-7146","authenticated-orcid":false,"given":"Raquel Revuelta","family":"Iniesta","sequence":"additional","affiliation":[{"name":"Children's Health and Exercise Research Centre (CHERC) Public Health and Sport Sciences Faculty of Health and Life Sciences University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8610-5417","authenticated-orcid":false,"given":"Alan R.","family":"Barker","sequence":"additional","affiliation":[{"name":"Children's Health and Exercise Research Centre (CHERC) Public Health and Sport Sciences Faculty of Health and Life Sciences University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1556-715X","authenticated-orcid":false,"given":"Dimitris","family":"Vlachopoulos","sequence":"additional","affiliation":[{"name":"Children's Health and Exercise Research Centre (CHERC) Public Health and Sport Sciences Faculty of Health and Life Sciences University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4422-479X","authenticated-orcid":false,"given":"Tom\u00e1\u0161","family":"Sl\u00e1ma","sequence":"additional","affiliation":[{"name":"Childhood Cancer Research Group Institute of Social and Preventive Medicine (ISPM), University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4511-287X","authenticated-orcid":false,"given":"Christina","family":"Schindera","sequence":"additional","affiliation":[{"name":"Childhood Cancer Research Group Institute of Social and Preventive Medicine (ISPM), University of Bern  Bern Switzerland"},{"name":"Division of Pediatric Oncology\/Hematology University Children's Hospital Basel, University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0037-4817","authenticated-orcid":false,"given":"Fabi\u00ebn N.","family":"Belle","sequence":"additional","affiliation":[{"name":"Childhood Cancer Research Group Institute of Social and Preventive Medicine (ISPM), University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines10123098"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3182a88099"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.3920"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.6296"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.43.4951"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b4606"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.7326\/M15-0424"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-09-0555"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00012-8"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/aac2.12042"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu16091315"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003410"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccao.2020.08.006"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.2196\/17724"},{"issue":"35","key":"e_1_2_9_16_1","first-page":"502","article-title":"The Swiss Childhood Cancer Registry: Rationale, Organisation and Results for the Years 2001\u20132005","volume":"137","author":"Michel G.","year":"2007","journal-title":"Swiss Medical Weekly"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20910"},{"key":"e_1_2_9_18_1","unstructured":"Children's Oncology Group.Long\u2010Term Follow\u2010up Guidelines for Survivors of Childhood Adolescent and Young Adult Cancers Version 6.0.2023."},{"key":"e_1_2_9_19_1","unstructured":"J.Sallis.2023.7 Day Physical Activity Recall (PAR) https:\/\/www.drjimsallis.com\/7\u2010day\u2010physical\u2010activity\u2010recall."},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyr142"},{"key":"e_1_2_9_21_1","unstructured":"Federal Department of Home Affairs.Eating Well and Staying Healthy. Swiss Nutrition Policy 2017\u20132024.2017 https:\/\/leap.unep.org\/en\/countries\/ch\/national\u2010legislation\/swiss\u2010nutrition\u2010policy\u20102017\u20102024."},{"key":"e_1_2_9_22_1","article-title":"Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation","volume":"894","author":"World Health Organization","year":"2000","journal-title":"World Health Organization Technical Report Series"},{"key":"e_1_2_9_23_1","volume-title":"Waist Circumference and Waist\u2013Hip Ratio: Report of a WHO Expert Consultation","author":"World Health Organization","year":"2008"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy339"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70323-6"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1200303"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114518000533"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12020591"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyw319"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2016.08.012"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27922"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25521"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1089\/jayao.2023.0063"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25071"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2016.00131"},{"key":"e_1_2_9_36_1","unstructured":"Federal Office of Public Health.Physical Activity Behavior (Age: 18+).2025 https:\/\/ind.obsan.admin.ch\/en\/indicator\/monam\/physical\u2010activity\u2010behavior\u2010age\u201018."},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0034930"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.894824"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.02.031"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2015-000358"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2020.02.47"},{"key":"e_1_2_9_42_1","unstructured":"Services U.S.D.o.H.a.H. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking\u2010Attributable Disease.2010."},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCGEN.119.002814"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27438"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-081823"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/1545-5017.70089","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/1545-5017.70089","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/1545-5017.70089","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:15:16Z","timestamp":1790169316000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/1545-5017.70089"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,7]]},"references-count":44,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1002\/1545-5017.70089"],"URL":"https:\/\/doi.org\/10.1002\/1545-5017.70089","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.22541\/au.175802053.32405177\/v1","asserted-by":"object"}]},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,7]]},"assertion":[{"value":"2025-09-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70089"}}