Key result
Gynaecologic cancer survivors without initial comorbidities had an increased risk of CHD and CVD events compared with non-cancer controls after 1 year of diagnosis (HR 1.101; 95% CI 1.020-1.189).
Why the study?
Few studies have evaluated the incidence of coronary heart disease and cerebrovascular disease among gynaecologic cancer survivors.
Does a history of gynaecologic cancer increase the risk of coronary heart disease and cerebrovascular disease compared to non-cancer controls?
Cohort (n=106,710)
Yes
Does a history of gynaecologic cancer increase the risk of coronary heart disease and cerebrovascular disease compared to non-cancer controls?
While overall risk is not increased, gynaecologic cancer survivors without baseline comorbidities have a persistently higher risk of coronary heart disease up to 10 years post-diagnosis, warranting cardiovascular surveillance.
Answers are grounded in this paper and cite their sources.
No overall CHD/CVD risk increase in gynaecologic cancer survivors; subgroup without comorbidities shows association, leaving targeted surveillance hypothesis-generating.
Only few studies have evaluated the incidence of coronary heart disease (CHD) and cerebrovascular disease (CVD) among gynaecologic cancer survivors. We selected 26,880 gynaecologic cancer patients who underwent health check-ups within 2 years after diagnosis using the Korean National Health Insurance Service Database. They were compared with 79,830 non-cancer controls. Cox regression models were used to estimate hazard ratios (HRs). There was no significant relationship between gynaecologic cancer survivors and CHD or CVD events. However, 10 years after diagnosing cancers, the risk of angina increased in cancer survivors (adjusted HR = 1.193, 95% CI: 1.013–1.406). After 1 year of diagnosis, cancer patients with no initial comorbidities showed an increased risk of all CHD and CVD events (adjusted HR = 1.101, 95% CI: 1.020–1.189) and CHD alone (adjusted HR = 1.168, 95% CI: 1.055–1.293) compared with controls. CHD risk was also higher in the cancer group with no comorbidities after 10 years of diagnosis (adjusted HR = 1.284, 95% CI: 1.020–1.615). Overall, the risk of CHD or CVD did not increase in gynaecologic cancer survivors. However, cancer patients without any comorbidities showed a higher risk of CHD compared with control, the risk persisting until 10 years after cancer diagnosis.Impact StatementWhat is already known on this subject? Cardiovascular risk and the incidence of stroke increase after cancer diagnosis.What do the results of this study add? The risk of coronary heart disease (CHD) and cerebrovascular disease did not increase in Asian (especially Korean) gynaecologic cancer survivors compared with the general population. However, cancer patients without any comorbidities showed a higher risk of CHD compared with the non-cancer population.What are the implications of these findings for clinical practice and/or further research? Our results imply the importance of surveillance of cardiovascular risks among patients with gynaecologic cancer without comorbidities.
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Cho et al. (2022) conducted a cohort in Gynaecologic cancer (ovarian, uterine, cervical) (n=106,710). Gynaecologic cancer vs. Non-cancer controls was evaluated on Coronary heart disease (CHD) and cerebrovascular disease (CVD) events. Gynaecologic cancer survivors without initial comorbidities had an increased risk of CHD and CVD events compared with non-cancer controls after 1 year of diagnosis (HR 1.101; 95% CI 1.020-1.189).
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