Heart disease risk higher in GU cancer survivors

Cancer survivors, particularly those who had genitourinary (GU) tumors, have an elevated 10-year risk of cardiovascular disease compared to the general population, according to research findings reported in PLOS ONE.^1,2

The study showed that 35.1% of cancer survivors had an elevated 10-year risk of atherosclerotic cardiovascular disease (ASCVD) compared with 23.4% of individuals with no cancer history. The average estimated 10-year ASCVD risks were 8.3% versus 5.1%, respectively. The 10-year risk was highest in GU cancer survivors, including bladder/kidney (odds ration [OR], 7.27), prostate cancer (OR, 9.45), and testicular cancer (OR, 11.47).

“The good news is that we’re getting really good at treating cancer and we have more survivors, but we need to start thinking more carefully about the non-cancer risks following a diagnosis, one of which is cardiovascular disease,” study senior author Ashley Felix, PhD, an associate professor of epidemiology at The Ohio State University, stated in a press release. “We don’t want people to survive cancer only to die prematurely of heart disease or stroke, so we need to make sure that cancer patients, and their health care team, are aware of this increased risk.”

For their analysis, the investigators applied statistical modeling to data from the National Health and Nutrition Examination Survey that was accrued between 2007 and 2016 for patients aged 40 to 79 years with no history of CVD. The study included data from 15,095 individuals with a mean age of 55.2 years. Overall, 12.3% (n = 1604) of patients self-reported a history of cancer.

Patient characteristics showed that 53% were female, 71.7% were non-Hispanic White, and 9.9% were non-Hispanic Black. Additionally, 32.4% had a college education or higher, and 70.3% were married.

The researchers noted that age was a significant modifier in the link between a history of cancer and the 10-year risk of ASCVD. Along this line, patients who were diagnosed with cancer between age 60 and 69 had significantly higher odds of having an increased 10-year ASCVD risk (OR, 2.24); however, cancer history did not appear to affect the odds of elevated 10-year ASCVD risk in other age-defined subgroups.

“If we continue to see the increasing incidence of cancer among younger adults, we can expect to see a larger burden of cardiovascular disease among those individuals—our future studies need to go in that direction,” stated Felix.

Also commenting on the study in the press release, lead researcher Xiaochen Zhang, a PhD candidate in Ohio State’s College of Public Health, stated, “The good news is that those younger individuals have a lot of time to make lifestyle changes that could move their cardiovascular risk in a positive direction. In addition to monitoring cancer survivors carefully for cardiovascular disease—and making them aware of the elevated risk—health care providers have the opportunity to guide patients toward interventions that can lower their risk.”

References

1. Zhang X, Pawlikowski M, Olivo-Marston S, et al. Ten-year cardiovascular risk among cancer survivors: the national health and nutrition examination survey. PLoS One. 2021;16(3):e0247919. doi: 10.1371/journal.pone.0247919

2. Cancer survivors face elevated heart disease risk, study finds. Published online March 17, 2021. Accessed March 17, 2021. https://bit.ly/3bWTUNc