Key result
Cardiovascular mortality rises ~2% annually in cancer patients despite falling cancer-related deaths.
Why the study?
While advances in cancer treatment have increased survival, long-term cancer survivors face elevated CVD risk, motivating an evaluation of temporal trends in cancer- and CVD-related incidence-based mortality rates across stages, primary sites, and counties in Texas.
Cohort
Yes
Among Texas cancer patients, cardiovascular mortality is rising even as cancer mortality declines, highlighting the need for early cardiovascular risk assessment and prevention in oncology care, particularly for high-survival and localized cancers.
Rising CVD mortality in cancer survivors warrants clinical vigilance for cardio-protection; leaves open whether targeted interventions can mitigate this trend.
Introduction Cancer and cardiovascular disease (CVD) are leading causes of death among Texas residents. While advances in cancer treatment have increased survival, long-term survivors face elevated CVD risk. We examined temporal trends in cancer- and CVD-related incidence-based mortality (IBM) rates among Texas residents diagnosed with cancer by cancer stage, primary site, and county, and associations between the CVD-to-cancer IBM ratio and survival. Methods Using Texas Cancer Registry data, this retrospective cohort study calculated cancer- and CVD-related IBM rates overall and by stage and the five sites with the highest cancer- and CVD-related deaths, and assessed annual percentage change (APC) using Joinpoint regression. County-level heatmaps displayed cumulative IBM rates and CVD-to-cancer IBM ratios, defined as CVD-related IBM rate divided by cancer-related IBM rate, by these groupings. Weighted Pearson correlations with bootstrap standard errors examined associations between CVD-to-cancer IBM ratios and 1- and 5-year survival among patients diagnosed during 2010-2015, followed through 2020. Results In 2010-2019, cancer-related IBM rates declined (APC = -2.51%, 95% CI -3.02 to -2.01, p < 0.001), while CVD-related IBM rates increased (APC = +1.87%, 95% CI 0.81-2.93, p < 0.001). Cancer-related IBM rates decreased, and CVD-related IBM rates generally increased across localized, regional, and distant-stage groups. CVD-to-cancer IBM ratios were higher for high-survival cancers including prostate and breast cancers. Across stages (n=4), correlations between CVD-to-cancer IBM ratio and survival were r = 0.81 (1-year) and r = 0.86 (5-year); inferential statistics were unobtainable. Across sites (n=29), correlations were r = 0.86 (5-year; 95% CI 0.80-0.93, p < 0.001) and r = 0.81 (1-year; 95% CI 0.74-0.89, p < 0.001). Conclusions Cancer-related IBM rates declined while CVD-related IBM rates increased, especially in localized-stage, high-survival sites, and specific Texas counties. Incorporating cardiovascular risk assessment and prevention early in cancer care, focusing on underserved areas, may improve long-term survival.
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Sohn et al. (2026) conducted a cohort in Cancer. Cancer diagnosis across temporal periods, stages, primary sites, and counties was evaluated on Temporal trends (annual percentage change) in cancer- and cardiovascular disease-related incidence-based mortality (IBM) rates (APC +1.87% (CVD IBM); APC -2.51% (Cancer IBM), 95% CI 0.81 to 2.93 (CVD IBM); -3.02 to -2.01 (Cancer IBM), p=<0.001). Among Texas cancer patients (2010-2019), cancer-related mortality declined (APC -2.51%, p<0.001) while cardiovascular mortality increased (APC +1.87%, p<0.001).
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