The unrecognized burden of cardiovascular risk factors in women newly diagnosed with endometrial cancer: A prospective case control study

BACKGROUND: Cardiovascular disease is a major cause of death in endometrial cancer survivors. The aim of this study was to determine whether women newly diagnosed with endometrial cancer have a higher prevalence of cardiovascular risk factors than the general population. METHODS: The prevalence of adequately treated and unrecognized/inadequately treated cardiovascular risk factors and the corresponding 10-year cardiovascular risk by QRISK2 score was measured in 150 consecutive women undergoing primary treatment for endometrioid endometrial cancer in the North West of England, and 746 age and ethnicity-matched control women from the Health Survey for England 2014. RESULTS: Women with endometrial cancer had higher proportions of obesity (BMI≥30 60.7% vs. 32.4%, p<0.0001) and a preponderance of unrecognized and inadequately treated cardiovascular risk factors. Compared with controls, endometrial cancer cases had a higher prevalence of incident hyperglycemia (57.2%vs.11.5%, p<0.0001), total: HDL cholesterol ratio>4.5 (26.7%vs.13.7%, p<0.0001), and were more likely to have three or more cardiovascular risk factors (22%vs.6%, p<0.0001). This equates to a higher 10-year cardiovascular risk (median QRISK2 score 12.6% vs. 8.8%, p<0.0001). Optimization of risk factors would have a greater impact on absolute cardiovascular disease risk for cases than controls (QRISK2 score reduction 1.8% vs. 0.7%). CONCLUSIONS: Women undergoing primary treatment for endometrial cancer have a higher prevalence of cardiovascular risk factors than women without the disease. Early identification and treatment of these risk factors could improve outcomes for endometrial cancer survivors.