Risk for Cardiovascular Disease Higher in Survivors of Testicular Cancer

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Testicular cancer survivors have an elevated risk of cardiovascular disease.
Testicular cancer survivors have an elevated risk of cardiovascular disease.

Testicular cancer survivors (TCSs) treated with chemotherapy have a high prevalence of metabolic abnormalities and are at an increased risk for cardiovascular disease (CVD), according to a study published in the Journal of the National Comprehensive Cancer Network.

Advancements in medicine have led to significantly improved cure rates among patients with testicular cancer; nearly 80% of patients are cured and have a 95% 5-year relative survival rate, but they also have a 7-fold increase in risk for CVD.


Previous studies have investigated the incidence of metabolic syndrome (MetS), a major risk factor for CVD, in TCSs, but results have been conflicting.

For the ongoing Platinum Study, researchers assessed the outcomes of 486 survivors of testicular cancer; patients were younger than 55 at diagnosis, received first-line platinum-based chemotherapy, and were disease-free at the time of evaluation. The participants completed a questionnaire that provided insight to patient lifestyle behaviors, and underwent a physical examination that provided clinical measures of health.


Results showed that 43.2% of survivors had hypertension vs 30.7% of control patients (P <.001), but were significantly less likely to have lower high-density lipoprotein (HDL) levels (23.7% vs 34.8%; P <.001) or truncal obesity (28.2% vs 40.1%; P <.001).

No significant difference in prevalence of MetS was seen between survivors and controls, nor any associations with type of treatment or the presence of rs523349

No significant difference in prevalence of MetS was seen between survivors and controls, nor any association with type of treatment or the presence of rs523349, a single nucleotide polymorphism previously associated with MetS.

Survivors were, however, significantly more likely to have higher levels of low-density lipoprotein (LDL), total cholesterol, and a higher body mass index, which are risk factors for CVD.

The authors concluded that “the etiology of MetS in cancer survivors likely differs from the general population, thus applying criteria developed for the general population to cancer survivors may underestimate CVD risk.… Providers are encouraged to screen and adequately treat [survivors of testicular cancer] for hypertension, dyslipidemia, and hypogonadism.”

Reference

Zaid MA, Gathirua-Mwangi WG, Fung C, et al. Clinical and genetic risk factors for adverse metabolic outcomes in North American testicular cancer survivors. J Natl Compr Canc Netw. 2018;16:257-265.

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