A population-based study of cardiovascular disease mortality risk in US cancer patients

This observational study characterized cardiovascular disease (CVD) mortality risk for multiple cancer sites, with respect to the following: (i) continuous calendar year, (ii) age at diagnosis, and (iii) follow-up time after diagnosis. The Surveillance, Epidemiology, and End Results program was used...

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Vydáno v:European heart journal Ročník 40; číslo 48; s. 3889
Hlavní autoři: Sturgeon, Kathleen M, Deng, Lei, Bluethmann, Shirley M, Zhou, Shouhao, Trifiletti, Daniel M, Jiang, Changchuan, Kelly, Scott P, Zaorsky, Nicholas G
Médium: Journal Article
Jazyk:angličtina
Vydáno: England 21.12.2019
Témata:
Aortic Aneurysm - pathology
Aortic Dissection - complications
Atherosclerosis - complications
Breast Neoplasms - complications
Breast Neoplasms - epidemiology
Cancer Survivors - statistics & numerical data
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - mortality
Case-Control Studies
Cause of Death
Cerebrovascular Disorders - complications
Endometrial Neoplasms - complications
Endometrial Neoplasms - epidemiology
Female
Follow-Up Studies
Heart Diseases - complications
Humans
Hypertension - complications
Male
Neoplasms - complications
Neoplasms - epidemiology
Neoplasms - mortality
Prostatic Neoplasms - complications
Prostatic Neoplasms - epidemiology
Research Design
Risk Factors
Time Factors
United States - epidemiology
Urinary Bladder Neoplasms - complications
Urinary Bladder Neoplasms - epidemiology
United States
Neoplasm
Cardio-oncology
SEER
Epidemiology
Heart disease
ISSN:1522-9645, 1522-9645
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Shrnutí:This observational study characterized cardiovascular disease (CVD) mortality risk for multiple cancer sites, with respect to the following: (i) continuous calendar year, (ii) age at diagnosis, and (iii) follow-up time after diagnosis. The Surveillance, Epidemiology, and End Results program was used to compare the US general population to 3 234 256 US cancer survivors (1973-2012). Standardized mortality ratios (SMRs) were calculated using coded cause of death from CVDs (heart disease, hypertension, cerebrovascular disease, atherosclerosis, and aortic aneurysm/dissection). Analyses were adjusted by age, race, and sex. Among 28 cancer types, 1 228 328 patients (38.0%) died from cancer and 365 689 patients (11.3%) died from CVDs. Among CVDs, 76.3% of deaths were due to heart disease. In eight cancer sites, CVD mortality risk surpassed index-cancer mortality risk in at least one calendar year. Cardiovascular disease mortality risk was highest in survivors diagnosed at <35 years of age. Further, CVD mortality risk is highest (SMR 3.93, 95% confidence interval 3.89-3.97) within the first year after cancer diagnosis, and CVD mortality risk remains elevated throughout follow-up compared to the general population. The majority of deaths from CVD occur in patients diagnosed with breast, prostate, or bladder cancer. We observed that from the point of cancer diagnosis forward into survivorship cancer patients (all sites) are at elevated risk of dying from CVDs compared to the general US population. In endometrial cancer, the first year after diagnosis poses a very high risk of dying from CVDs, supporting early involvement of cardiologists in such patients.
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ISSN:1522-9645
1522-9645
DOI:10.1093/eurheartj/ehz766