Key result
Cardio-oncology survivorship is linked to ~134% higher odds of functional limitations, exceeding either condition alone.
Why the study?
Cardio-oncology traditionally focuses on cardiotoxicity prevention and acute cardiovascular events, leaving the functional, vocational, and mental health challenges of daily survivorship largely hidden.
Does cardio-oncology multi-morbidity increase the burden of functional disability and work limitations compared to cancer or CVD alone in U.S. adults?
Cross-Sectional (n=32,599)
Yes
Does cardio-oncology multi-morbidity increase the burden of functional disability and work limitations compared to cancer or CVD alone in U.S. adults?
Cardio-oncology survivors experience a profound functional and vocational burden that significantly exceeds that of cancer or CVD alone, highlighting the need for routine functional screening and early rehabilitation.
Answers are grounded in this paper and cite their sources.
Cardio-oncology survivors face excess functional limitations beyond cancer or CVD alone; hypothesis-generating and requires prospective studies before guiding care.
e24014 Background: Cardio-oncology traditionally focuses on cardiotoxicity prevention and acute cardiovascular-events. However, the functional, vocational, and mental health challenges that define daily survivorship remain largely hidden, representing a critical gap in holistic care. Methods: Utilizing the 2024 National Health Interview Survey (NHIS), we analyzed a nationally representative cohort of U.S. adults (≥18 years) across four groups: (1) Controls (no cancer or CVD), (2) CVD only, (3) cancer only, and (4) cardio-oncology. We evaluated five patient-centered metrics reflecting quality of life: functional and work limitations, assistive equipment use, personal assistance needs, and overall disability. Multivariable regression models, using Taylor series linearization for complex survey weighting, were adjusted for age, sex, race, hypertension, diabetes, hyperlipidemia, smoking, psychological distress (K6 score), and insurance status. Results: Among 32,599 adults (Weighted N = 259.7M), 2.9% lived with cardio-oncology multi-morbidity (weighted N = 5.34M; mean age 73y). After multivariable adjustment, functional limitations were highest in the cardio-oncology (63.6%, OR 2.34 [95%CI 1.89-2.88]), exceeding both CVD only (OR 1.99) and cancer only (OR = 1.26) groups. This population was also at the highest risk of disability (OR 2.74) and work limitations (31.7%, OR = 2.53). One in five cardio-oncology survivors reported severe mobility impairment (difficulty walking/steps), with a need for assistive equipment (OR = 2.86) and personal assistance (OR = 1.38). Conclusions: Cardio-oncology survivors face a functional and vocational burden significantly exceeding that of cancer or CVD alone. Care models must expand beyond event prevention to integrate routine functional screening and early rehabilitation to preserve quality of life in this high-risk population. Adjusted odds ratios by disease phenotype. Outcome CVD Only (vs. Control) Cancer Only (vs. Control) Cardio-Oncology (vs. Control) OR (95% CI) OR (95% CI) OR (95% CI) Functional limitation 1.99 (1.75–2.28) 1.26 (1.14–1.39) 2.34 (1.89–2.88) Uses special equipment 2.56 (2.20–2.98) 1.26 (1.08–1.46) 2.86 (2.32–3.53) Needs assistance 1.51 (1.17-1.94) 0.84 (0.64-1.12) 1.38 (0.99-1.92) Work limitation 2.12 (1.88-2.39) 1.19 (1.07-1.33) 2.53 (2.11-3.03) Disability 2.20 (1.90–2.56) 1.11 (0.96–1.29) 2.74 (2.26–3.32) Note: Models adjusted for age, sex, race, hypertension, diabetes, hyperlipidemia, smoking status, psychological distress, and insurance type. Reference group = Adults with no history of cancer or CVD. CVD = Cardiovascular disease; OR = Odds Ratio; CI = Confidence Interval.
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Patel et al. (2026) conducted a cross-sectional in Cardio-oncology survivorship (n=32,599). Cardio-oncology multi-morbidity vs. Controls (no cancer or CVD) was evaluated on Functional limitation (OR 2.34, 95% CI 1.89-2.88). Cardio-oncology survivors had higher odds of functional limitations compared to controls, exceeding the burden of CVD or cancer alone.
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