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June 17, 2023Cardio-OncologyOpen Access

Cancer survivors >12 months post-treatment show no increased AF risk versus the general population.

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Why the study?

It is unclear whether cancer survivors have an increased risk of AF compared to the general population, and specific screening recommendations for oncology patients are lacking.

Does cancer survivorship (>12 months post-treatment) increase the risk of atrial fibrillation compared to the general population?

Population

Sixteen studies of adults >18 years who were >12 months post completion of cancer treatment

Comparison

Cancer survivors compared to the general population

Design

Systematic review and meta-analysis

Key result

Cancer survivors >12 months post-treatment had a combined annualized atrial fibrillation rate of 0.7%, which was not significantly increased compared to the general population.

Authors

YBYueyang BaoJLJohn LeeUTUdit Thakur

Discussion

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Member takes

Overview

May support AF screening in cancer survivors; leaves open whether detection rates exceed general population enough to change guidelines.

Study Design

Type

Meta-Analysis (n=1,406,464)

Structured PICO

Does cancer survivorship (>12 months post-treatment) increase the risk of atrial fibrillation compared to the general population?

P
Population
1,406,464 adult cancer survivors >12 months post-treatment across 16 studies, evaluated for the annualized rate of atrial fibrillation.
C
Comparator
General population
O
Outcome
Overall atrial fibrillation (AF) detection rate and combined annualised AF ratehard clinical

Cancer survivors >12 months post-treatment do not appear to have a significantly increased rate of atrial fibrillation compared to the general population, though high study heterogeneity warrants caution.

Limitations

  • Significant heterogeneity amongst the individual studies with regards to study design and patient demographics
  • Details of cancer treatments given were poorly reported
  • AF definitions varied amongst studies and lack of use of modern screening technologies
  • Medication history and risk factor management was not documented
  • Limited reporting of vascular risk factors and risk scores such as CHA2DS2-VASc
  • Some cancer types known to be associated with elevated AF risk such as lung cancer and haematological malignancies were not well represented
  • Significant heterogeneity between studies (I2 = 99.8%)

Cite This Study

Bao et al. (2023) conducted a meta-analysis in Cancer (n=1,406,464). Cancer survivorship (>12 months post-treatment) vs. General population was evaluated on Annualized rate of atrial fibrillation (95% CI 0.1-0.98). Cancer survivors >12 months post-treatment had a combined annualized atrial fibrillation rate of 0.7%, which was not significantly increased compared to the general population.

synapsesocial.com/papers/6a5c2a87ad0d18cf2f1e99a2https://doi.org/10.1186/s40959-023-00180-3
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