Date of Conferral

2023

Degree

Ph.D.

School

Public Health

Advisor

Leah Miller

Abstract

Cancer and obesity rates continue to rise, creating enormous public heath burdens to the individual and at the national and global levels, reducing quality of life, and increasing spending. Moreover, the relationships between cancer and obesity are not well understood. A commonly used chemotherapy for several types of cancer is high dose methotrexate (HDMTX). Along with chemotherapy, especially at high doses, comes toxicity to specific organs and the entire body. However, limited research has been conducted on obese cancer patients as they are often excluded from clinical studies. Practitioners need to better understand how to dose these patients to provide the best treatment outcomes. The purpose of this retrospective cross-sectional analysis was to investigate the association between HDMTX and toxicity in the kidney and liver in cancer patients, controlling for body mass index (BMI), age, and sex as well as comedication for participants in the Guardian Research Network database with several types of cancer. Using the health belief model as a theoretical foundation, single and multiple logistic regression was used for this analysis. The results demonstrated that there was no association between BMI or BMI and comedication on liver toxicity or kidney toxicity without any other predictors. Females had a significantly higher odds ratio of liver toxicity as compared to males. There was a small association between kidney toxicity and age, although it was just under the significance level. This was the first study of its kind, so more research is needed to confirm these findings, adding more covariates to understand where the differences in toxicity lie to help promote better outcomes for the obese cancer patient.

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