Socioeconomic factors like lack of private insurance, food insecurity, and low education were independently associated with prevalent cardiovascular disease specifically among cancer survivors.
Cross-Sectional (n=15,517)
Are socioeconomic, lifestyle, and clinical factors associated with prevalent cardiovascular events in adult cancer survivors compared to a matched non-cancer cohort?
Socioeconomic disadvantages, including lack of private insurance and food insecurity, are independently associated with prevalent cardiovascular disease in cancer survivors, highlighting the need to address social determinants of health in cardio-oncology.
Background: Cardiovascular disease (CVD) is a leading cause of mortality among cancer survivors, yet the contributions of socioeconomic, lifestyle, and clinical factors to CVD remain unexplored. Objective: This study was aimed at examining associations between these factors and prevalent CVD in adults with prior cancer and comparing them with those in a matched non-cancer cohort. Methods: We analyzed 97,648 adults from the National Health and Nutrition Examination Survey. Associations of socioeconomic, lifestyle, and clinical factors with a composite endpoint of five self-reported cardiovascular events were assessed with multivariable logistic regression. Interaction analyses assessed differences by cancer status, and sensitivity analyses examined individual cardiovascular outcomes. Results: We included 5584 cancer survivors and 9933 matched participants without cancer. Age, sex, unemployment, low income, current smoking, obesity, diabetes, hypertension, and hypercholesterolemia were associated with elevated odds of CVD prevalence in both groups. Among only cancer survivors, an absence of private insurance, or the presence of food insecurity or low educational attainment, was also independently associated with CVD prevalence. Sensitivity analyses indicated broadly consistent results across individual outcomes. Conclusions: Socioeconomic, lifestyle, and clinical factors were associated with prevalent CVD among cancer survivors, with socioeconomic disadvantage contributing to disparities in CVD burden. Because the outcomes were self-reported, and the study was cross-sectional, the findings should be interpreted as associative rather than causal or predictive.
Shi et al. (2026) conducted a cross-sectional in Prior cancer (n=15,517). Socioeconomic, lifestyle, and clinical factors vs. Absence of risk factors / Matched non-cancer cohort was evaluated on Composite endpoint of five self-reported cardiovascular events. Socioeconomic factors like lack of private insurance, food insecurity, and low education were independently associated with prevalent cardiovascular disease specifically among cancer survivors.