We identified no difference in the presence of diabetes or diabetes control between CRC cases and matched controls in the year following CRC diagnosis. During the same time period, we found that hyperlipidemia was better controlled among CRC survivors. This may merit additional study. However, we found that CRC survivors may be more likely to have hypertension and may be more likely to struggle with blood pressure control in the years following their CRC diagnosis.

There may be a need to address care for hypertension, a CVD-related chronic condition, among CRC survivors, and to understand the impact of CRC treatment on development and management of hypertension. Future studies should evaluate adherence to antihypertensives medications and how the management of hypertension among CRC survivors is relative to their peers. There may be a need for blood pressure control interventions targeted toward cancer survivors.

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We thank the Veterans Affairs cancer registrars and VA Central Cancer Registry staff for their data collection and related efforts. This study is supported by a VA Health Services Research and Development (HSR&D) Career Development Award (CDA 13-025) awarded to Dr Leah L. Zullig. This study is also supported by a Veterans Affairs Health Services Research and Development Senior Career Scientist Award (HSRD 08-027) awarded to Dr Hayden B Bosworth. This work was supported by the Center of Innovation for Health Services Research in Primary Care (CIN 13-410) at the Durham VA Health Care System. This work was previously presented at the American Society of Medical Oncology (ASCO) Cancer Survivorship Symposium in March 2018; the abstract was published in a supplemental issue of the Journal of Clinical Oncology.

Leah L. Zullig,1,2 Valerie A Smith,1,2 Jennifer H. Lindquist,1 Christina D. Williams,3,4 Morris Weinberger,1,5 Dawn Provenzale,1,4 George L. Jackson,1,2 Michael J. Kelley,6–8 Susanne Danus,1 Hayden B. Bosworth1,2,9

1Center for Health Services Research in Primary Care, Durham Veterans Affairs Health Care System, Durham, NC, USA; 2Department of Population Health Sciences, Duke University, Durham, NC, USA; 3Division of Medical Oncology, Department of Medicine, Duke University, Durham, NC, USA; 4Cooperative Studies Program Epidemiology Center, Durham, NC, USA; 5Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC, USA; 6Office of Specialty Care Services, Department of Veterans Affairs, Washington, DC, USA; 7Hematology-Oncology Service, Durham Veterans Affairs Medical Center, Durham, NC, USA; 8Department of Medicine, Duke University, Durham, NC, USA; 9Departments of Psychiatry and School of Nursing, Duke University, Durham, NC, USA


Dr Leah L Zullig reports grants from Department of Veterans Affairs, during the conduct of the study. Dr George L Jackson reports grants from Department of Veterans Affairs, during the conduct of the study and grants from Bristol-Myers Squibb Foundation, outside of the submitted work. Dr Hayden B Bosworth reports grants from Johnson & Johnson, Improve Patient Outcomes, Cover MyMeds, and Omnicell. He also received grants and personal fees from Otsuka and Sanofi, outside of the submitted work. The authors report no other conflicts of interest in this work.


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