Risk varies by cardiovascular outcome and site of 20 common cancers
THURSDAY, Aug. 29, 2019 (HealthDay News) — Cancer survivors face an increase in the long-term risk for cardiovascular disease, according to a study published online Aug. 20 in The Lancet.
Helen Strongman, from the London School of Hygiene & Tropical Medicine, and colleagues used linked primary care, hospital, and cancer registry data from the U.K. Clinical Practice Research Datalink (1990 through 2015) to identify 108,215 adult survivors of the 20 most common cancers who were alive 12 months after diagnosis. Risks for a range of cardiovascular disease outcomes were compared to those among 523,541 controls without a history of cancer and matched for age, sex, and general practice.
The researchers found that venous thromboembolism risk was higher in survivors of 18 of 20 site-specific cancers compared with that of controls, with adjusted hazard ratios (HRs) ranging from 1.72 in patients after prostate cancer to 9.72 after pancreatic cancer. Over time, HRs decreased but remained elevated more than five years after diagnosis. There were increased risks for heart failure or cardiomyopathy in patients after 10 of 20 cancers, including hematological (adjusted HRs, 1.94 with non-Hodgkin lymphoma; 1.77 with leukemia; and 3.29 with multiple myeloma), esophageal (1.96), lung (1.82), kidney (1.73), and ovarian (1.59). For multiple cancer types, elevated risks for arrhythmia, pericarditis, coronary artery disease, stroke, and valvular heart disease were also seen. Absolute excess risks were generally greater with increasing age, although HRs for heart failure or cardiomyopathy and venous thromboembolism were greater in patients without previous cardiovascular disease and in younger patients. Overall, the increased risk for cardiovascular disease was greatest in patients who had received chemotherapy.
“There is limited guidance at present to help doctors manage cardiovascular risk in cancer survivorship, and further evidence is needed on whether routine monitoring or additional preventative measures would benefit those with the highest risks,” a coauthor said in a statement.
Several authors disclosed financial ties to pharmaceutical companies.
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