|The following article features coverage from the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting. Click here to read more of Oncology Nurse Advisor‘s conference coverage.|
Non-Hispanic Black (NHB) and Hispanic adult survivors of childhood cancers had a higher burden of cardiovascular risk factors (CVRF) compared with non-Hispanic White (NHW) survivors, according to results of a study presented at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting.
The study objectives were to identify disparities in the incidence of CVRFs by race/ethnicity among survivors of childhood cancer and to determine whether disparities in CVRFs by race/ethnicity among survivors are greater than those identified compared to siblings and with the general population, which could inform strategies to reduce health inequities among survivors.
The investigators leveraged data from the Childhood Cancer Survivorship Study (CCSS), a retrospective cohort study with prospective follow-up. The CCSS comprises 25,579 5- year survivors of childhood cancer diagnosed between 1970 and 1999. The team estimated the incidence of self-reported grade 2 or higher CVRFs (hypertension, diabetes, dyslipidemia, and obesity) and multiple (more than 2) CVRFs among survivors. Statistical analyses were adjusted for key treatment exposures (Yes/No for anthracyclines, alkylators, and chest radiation) and sociodemographic data (age, sex, household income, education, marital status, employment, and insurance).
From the CCSS cohort, 20,416 NHW, 1625 NHB, and 2043 Hispanic survivors with the cumulative incidence estimates of each CVRF at age 40 were included in the study. NHB survivors were more likely to report hypertension (unadjusted RR 1.3; 95% CI, 1.0-1.6), diabetes (RR, 1.6; 95% CI, 1.0-2.4), obesity (RR, 1.6; 95% CI, 1.4-1.9), and multiple CVRFs (RR, 1.3; 95% CI, 1.2-1.5) compared with NHW survivors. Hispanic survivors were more likely to report diabetes (RR, 1.7; 95% CI, 1.2-2.4), obesity(RR, 1.4; 95% CI, 1.2-1.5), and multiple CVRFs (RR, 1.1; 95% CI, 1.0-1.3) compared with NHW survivors. These results were consistent after adjustment for sociodemographic factors and treatment exposures.
For nearly all cardiovascular risk factors in the analysis, no associations between the incidence rate ratio by race/ethnicity and the survivor sibling cohorts were identified. However, NHB survivors were less likely to report hypertension or to be on antihypertensive medications compared with NHB participants the CCSS sibling cohort, a finding that warrants further investigation.
“The associated morbidity of these conditions and established increase they incur in risk of more severe cardiovascular disease emphasizes the need for interventions to mitigate CVRFs to promote health equity among these survivors,” concluded the authors.
Disclosure: This study was supported by the US National Institutes of Health. Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please refer to the original reference for a full list of authors’ disclosures.
Read more of Oncology Nurse Advisor’s coverage of the 2021 ASCO Annual Meeting by visiting the conference page.
Noyd DH, Yasui Y, Li N, et al. Disparities in cardiovascular risk factors by race/ethnicity among adult survivors of childhood cancer: a report from the Childhood Cancer Survivorship Study (CCSS). J Clin Oncol. 2021;39(suppl 15; abstr 10017). doi:10.1200/JCO.2021.39.15_suppl.10017