Key result
Cancer diagnosis in 2005-2012 is linked to ~37% lower cardiovascular mortality risk versus 1990-1994.
Cohort (n=301,923)
Yes
Hazard Ratio: 0.63 (95% CI 0.54–0.72)
p-value: p=<0.001
Cardiovascular mortality has significantly decreased over the past two decades among young adult survivors of major cancers, driven mainly by improvements in lung and breast cancers.
CVM surveillance may warrant consideration in young cancer survivors; leaves open causal drivers and targeted prevention trials.
AIM: To describe the incidence of cardiovascular mortality (CVM) in survivors of major cancers and identify its trends over the past two decades. METHODS: We used the surveillance, epidemiology and end-results 19 registry to identify young adults (20-49 years), diagnosed with the following major primary cancers: Lung, breast, liver/intrahepatic bile duct, pancreas, prostate, colorectal, and ovarian from 1990 through 2012 and identified the cumulative incidence of CVM after adjusting for confounding factors. RESULTS: We identified a total of 301923 cancers (breast 173748, lung 38938, colorectal 31722, prostate 22848, ovary 16065, liver 9444, pancreas 9158). A total of 2297 (0.8%) of patients had incident CVM. Lung (10-year cumulative CVM 2.4%) and liver (1.73%) cancers had the highest incidence of CVM, while breast (0.6%) and prostate (1.2%) had the lowest CVM mortality, even after multiple adjustments (P < 0.001). Overall, there was a significant improvement in CVM since 1990 [2005-2012 vs 1990-1994, adjusted HR 0.63 (0.54-0.72), P < 0.001]. This was driven by improvements in CVM in lung cancers (P = 0.02), breast (P < 0.001), and a trend in ovarian cancer (P = 0.097). There was no statistically significant improvement in CVM among survivors of colorectal, pancreatic, liver, or prostate cancers. CONCLUSION: The risk of CVM differs among different cancers, and is highest among survivors of lung and liver cancers. The incidence of CVM has decreased over the past 2 decades mainly among survivors of lung and breast cancers.
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Al‐Kindi et al. (2016) conducted a cohort in Major primary cancers (n=301,923). Diagnosis in 2005-2012 vs. Diagnosis in 1990-1994 was evaluated on Cardiovascular mortality (CVM) (adjusted HR 0.63, 95% CI 0.54-0.72, p=<0.001). Cancer diagnosis in 2005-2012 was associated with a significantly lower risk of cardiovascular mortality compared to 1990-1994 (adjusted HR 0.63; 95% CI 0.54-0.72; P<0.001).
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