A Review of Cardiorespiratory Fitness in Adolescent and Young Adult Survivors of Childhood Cancer: Factors that Affect its Decline and Opportunities for Intervention

Childhood cancer incidence and survivorship rates are increasing, leading to a growing population of survivors that are at risk for competing causes of death, most notably cardiovascular disease (CVD). Cardiorespiratory fitness (CRF), a key modifiable CVD risk factor, is lower than expected among childhood survivors 5-20 years post-diagnosis. This review discusses the studies that demonstrate lower CRF in survivors of childhood cancer and the potential mechanisms and factors contributing to lower CRF in this population. Both exercise interventions and strategies to improve CRF are considered. The review advocates for more robust clinical research and exercise interventions to improve CRF with the goal of reducing comorbidities and competing CVD risk among childhood cancer survivors into adolescence and young adulthood.