e24140 Background: It is well-accepted that metabolic syndrome can drive cancer development through changes in insulin signaling and inflammation. Cancer therapy itself has been associated with adverse metabolic effects that persist beyond active therapy. Both increase cardiovascular risk and may increase cancer recurrence risk in survivorship. Systemic therapy has been linked to disruptions in glucose and lipid metabolism, increased insulin resistance, elevated fasting glucose and hemoglobin A1c (HgbA1c), and unfavorable lipid changes such as increased low-density lipoprotein (LDL). In the United States, approximately 0.33% of the total population are newly diagnosed with diabetes and 0.23% are newly diagnosed with hyperlipidemia annually. Methods: To assess these observations in a real-life setting, we retrospectively examined metabolic outcomes in persons undergoing systemic cancer therapy—chemotherapy or hormonal therapy—or local therapy for breast, colon, ovarian, or lung cancer between January 1, 2022, and December 31, 2025. Inclusion criteria were breast, colon, ovarian, or lung cancer diagnosis; normal HgbA1c or LDL level prior to cancer therapy; received chemotherapy, radiotherapy, or hormonal therapy within 12 months of lab studies, and repeat metabolic testing within 12 months of cancer treatment completion. The primary outcome was the proportion of patients who developed abnormal (elevated) HgbA1c or LDL levels following treatment. Results: A total of 685 persons received chemotherapy and underwent pre- and post-treatment metabolic testing. Of these, 152 (breast cancer (56), colon cancer (32), ovarian cancer (15), and lung cancer (49): 22.2%) demonstrated abnormal post-treatment Hgb A1c or LDL values. A total of 718 persons received radiotherapy with pre- and post-treatment metabolic testing; 93 (breast cancer (63), colon cancer (6), ovarian cancer (1), and lung cancer (23): 13.0%) developed abnormal findings. A total of 804 persons received hormonal therapy alone for breast cancer with pre- and post-treatment metabolic testing; 158 developed abnormal Hgb A1c or LDL values at follow-up. A breakdown by cancer type is shown in the table below. Conclusions: In this retrospective real-world analysis, cancer therapy whether local or systemic was associated with a higher incidence of developing abnormal post-treatment HgbA1c and LDL levels compared to population data. These findings demonstrate increased risk for cardiovascular disease and potentially cancer recurrence that arises from metabolic disruption due to cancer therapy. Our data highlight the importance of metabolic evaluation and risk-reduction strategies in survivorship care. Abnormal Post-Treatment HgbA1c or LDL Chemo (N= 685) Radiation (N= 718) Hormonal (N=804) Breast 56 63 158 Colon 32 6 NA Ovarian 15 1 NA Lung 49 23 NA Total 152 (22.2%) 93 (13.0%) 158 (19.7%)
Lopez et al. (Thu,) studied this question.