Key result
Older age linked to up to ~11-fold higher CVD mortality across major gastrointestinal cancers.
Why the study?
Age is a known risk factor for cardiovascular disease-related mortality, but few studies have focused on the relationship between age and cardiovascular disease mortality among patients with major gastrointestinal cancers.
Is age associated with cardiovascular disease-related mortality in patients with major gastrointestinal cancers?
Cohort (n=576,713)
Yes
Is age associated with cardiovascular disease-related mortality in patients with major gastrointestinal cancers?
Effect estimate: sub-hazard ratio 11.23 (95% CI 9.50-13.27)
Age is a significant risk factor for cardiovascular disease-related mortality among patients with major gastrointestinal cancers, who experience higher CVD mortality than the general U.S. population.
May inform age-specific CVD monitoring in GI cancers; leaves open whether interventions reduce mortality.
BACKGROUND: Studies have reported age as a risk factor for cardiovascular disease (CVD)-related mortality; however, only a few studies have focused on the relationship between age and CVD-related mortality, especially among major gastrointestinal cancers. METHOD: The present retrospective cohort enrolled patients with colorectal, pancreatic, hepatocellular, gastric, and esophageal cancer between 2000 to 2015 from the Surveillance, Epidemiology and End Results Registry (SEER). Standardized mortality ratio (SMR), competing risk regression, and restricted cubic spline (RCS) analyses were used in our study. RESULTS: We analyzed 576,713 patients with major gastrointestinal cancers (327,800 patients with colorectal cancer, 93,310 with pancreatic cancer, 69,757 with hepatocellular cancer, 52,024 with gastric cancer, and 33,822 with esophageal cancer). Overall, CVD-related mortality gradually decreased every year, and the majority were older patients. All cancer patients had a higher CVD-related mortality rate than the general U.S. POPULATION: The adjusted sub-hazard ratios for middle-aged with colorectal cancer, pancreatic cancer, hepatocellular cancer, gastric cancer, and esophageal cancer were 2.55 (95% CI: 2.15-3.03), 1.77 (95% CI: 1.06-2.97), 2.64 (95% CI: 1.60-4.36), 2.15 (95% CI: 1.32-3.51), and 2.28 (95% CI: 1.17-4.44), respectively. The adjusted sub-hazard ratios for older patients with colorectal cancer, pancreatic cancer, hepatocellular cancer, gastric cancer, and esophageal cancer were 11.23 (95% CI: 9.50-13.27), 4.05 (95% CI: 2.46-6.66), 4.47 (95% CI: 2.72-7.35), 7.16 (95% CI: 4.49-11.41), and 4.40 (95% CI: 2.28-8.48), respectively. A non-linear relationship between age at diagnosis and CVD-related mortality was found in colorectal cancer, pancreatic cancer, and esophageal cancer; their reference ages were 67, 69, and 66 years old, respectively. CONCLUSION: This study demonstrated that age was a risk factor for CVD-related mortality among major gastrointestinal cancers.
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Liu et al. (2023) conducted a cohort in Major gastrointestinal cancers (n=576,713). Older age vs. Younger age was evaluated on CVD-related mortality (sub-hazard ratio 11.23, 95% CI 9.50-13.27). Older age was associated with higher CVD-related mortality across major gastrointestinal cancers, with adjusted sub-hazard ratios up to 11.23 (95% CI: 9.50-13.27) in colorectal cancer.
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