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Cardiovascular Disease Among Survivors of Adult-Onset Cancer: A Community-Based Retrospective Cohort Study.

Publication ,  Journal Article
Armenian, SH; Xu, L; Ky, B; Sun, C; Farol, LT; Pal, SK; Douglas, PS; Bhatia, S; Chao, C
Published in: J Clin Oncol
April 1, 2016

PURPOSE: Cardiovascular diseases (CVDs), including ischemic heart disease, stroke, and heart failure, are well-established late effects of therapy in survivors of childhood and young adult (< 40 years at diagnosis) cancers; less is known regarding CVD in long-term survivors of adult-onset (≥ 40 years) cancer. METHODS: A retrospective cohort study design was used to describe the magnitude of CVD risk in 36,232 ≥ 2-year survivors of adult-onset cancer compared with matched (age, sex, and residential ZIP code) noncancer controls (n = 73,545) within a large integrated managed care organization. Multivariable regression was used to examine the impact of cardiovascular risk factors (CVRFs; hypertension, diabetes, dyslipidemia) on long-term CVD risk in cancer survivors. RESULTS: Survivors of multiple myeloma (incidence rate ratio [IRR], 1.70; P < .01), carcinoma of the lung/bronchus (IRR, 1.58; P < .01), non-Hodgkin lymphoma (IRR, 1.41; P < .01), and breast cancer (IRR, 1.13; P < .01) had significantly higher CVD risk when compared with noncancer controls. Conversely, prostate cancer survivors had a lower CVD risk (IRR, 0.89; P < .01) compared with controls. Cancer survivors with two or more CVRFs had the highest risk of CVD when compared with noncancer controls with less than two CVRFs (IRR, 1.83 to 2.59; P < .01). Eight-year overall survival was significantly worse among cancer survivors who developed CVD (60%) when compared with cancer survivors without CVD (81%; P < .01). CONCLUSION: The magnitude of subsequent CVD risk varies according to cancer subtype and by the presence of CVRFs. Overall survival in survivors who develop CVD is poor, emphasizing the need for targeted prevention strategies for individuals at highest risk of developing CVD.

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Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

April 1, 2016

Volume

34

Issue

10

Start / End Page

1122 / 1130

Location

United States

Related Subject Headings

  • Survivors
  • Smoking
  • Risk Factors
  • Retrospective Studies
  • Registries
  • Proportional Hazards Models
  • Poisson Distribution
  • Oncology & Carcinogenesis
  • Obesity
  • Neoplasms
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Armenian, S. H., Xu, L., Ky, B., Sun, C., Farol, L. T., Pal, S. K., … Chao, C. (2016). Cardiovascular Disease Among Survivors of Adult-Onset Cancer: A Community-Based Retrospective Cohort Study. J Clin Oncol, 34(10), 1122–1130. https://doi.org/10.1200/JCO.2015.64.0409
Armenian, Saro H., Lanfang Xu, Bonnie Ky, Canlan Sun, Leonardo T. Farol, Sumanta Kumar Pal, Pamela S. Douglas, Smita Bhatia, and Chun Chao. “Cardiovascular Disease Among Survivors of Adult-Onset Cancer: A Community-Based Retrospective Cohort Study.J Clin Oncol 34, no. 10 (April 1, 2016): 1122–30. https://doi.org/10.1200/JCO.2015.64.0409.
Armenian SH, Xu L, Ky B, Sun C, Farol LT, Pal SK, et al. Cardiovascular Disease Among Survivors of Adult-Onset Cancer: A Community-Based Retrospective Cohort Study. J Clin Oncol. 2016 Apr 1;34(10):1122–30.
Armenian, Saro H., et al. “Cardiovascular Disease Among Survivors of Adult-Onset Cancer: A Community-Based Retrospective Cohort Study.J Clin Oncol, vol. 34, no. 10, Apr. 2016, pp. 1122–30. Pubmed, doi:10.1200/JCO.2015.64.0409.
Armenian SH, Xu L, Ky B, Sun C, Farol LT, Pal SK, Douglas PS, Bhatia S, Chao C. Cardiovascular Disease Among Survivors of Adult-Onset Cancer: A Community-Based Retrospective Cohort Study. J Clin Oncol. 2016 Apr 1;34(10):1122–1130.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

April 1, 2016

Volume

34

Issue

10

Start / End Page

1122 / 1130

Location

United States

Related Subject Headings

  • Survivors
  • Smoking
  • Risk Factors
  • Retrospective Studies
  • Registries
  • Proportional Hazards Models
  • Poisson Distribution
  • Oncology & Carcinogenesis
  • Obesity
  • Neoplasms