Risk for cardiovascular disease (CVD) in survivors of adult-onset cancer varies according to cancer type and the presence of cardiovascular risk factors (CVRFs), a study published online ahead of print in the Journal of Clinical Oncology has shown.1
Ischemic heart disease, stroke, and heart failure, are well-established late effects of cancer therapy in cancer survivors who were younger than 40 years at diagnosis. However, less is known about CVD risks in long-term survivors who were 40 years and older (adult-onset cancer) at diagnosis.
In this retrospective cohort study, researchers compared CVD incidence in survivors of adult-onset cancer (n = 36 232) with that of 73 545 noncancer controls within a large integrated managed care organization.
Noncancer controls were matched for age, sex, and residential ZIP code. Multivariable regression was used to examine the impact of CVRFs (hypertension, diabetes, dyslipidemia) on long-term CVD risk in cancer survivors.
Study results show CVD risk was significantly higher in survivors of multiple myeloma, carcinoma of the lung/bronchus, non-Hodgkin lymphoma, and breast cancer compared with risks in the noncancer controls. Conversely, CVD risk was lower in prostate cancer survivors compared with noncancer controls.
Presence of 2 or more CVRFs further increased the risk for survivors compared with noncancer controls with less than 2 CVRFs. Cancer survivors who developed CVD (60%) had significantly worse 8-year overall survival than cancer survivors without CVD (81%).
The researchers conclude the degree of subsequent CVD risk varies according to cancer subtype and presence and number of CVRFs. These results demonstrate that targeted prevention strategies are needed for those at highest risk of developing CVD.
1. Armenian SH, Xu L, Ky B, et al. Cardiovascular disease among survivors of adult-onset cancer: a community-based retrospective cohort study [published online ahead of print February 1, 2016]. J Clin Oncol. doi:10.1200/JCO.2015.64.0409.