Risk of cardiovascular disease in cancer survivors: A cohort study of 446,384 New Zealand primary care patients.

Tawfiq, E; Pylypchuk, R; Elwood, JM; McKeage, M; Wells, S; Selak, V

Risk of cardiovascular disease in cancer survivors: A cohort study of 446,384 New Zealand primary care patients.

Tawfiq, E Pylypchuk, R

Elwood, JM McKeage, M Wells, S Selak, V

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Publisher:: WILEY
Publication Type:: Journal Article
Citation:: Cancer Med, 2023, 12, (19), pp. 20081-20093
Issue Date:: 2023-10

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Field	Value	Language
dc.contributor.author	Tawfiq, E
dc.contributor.author	Pylypchuk, R https://orcid.org/0000-0002-8507-0467
dc.contributor.author	Elwood, JM
dc.contributor.author	McKeage, M
dc.contributor.author	Wells, S
dc.contributor.author	Selak, V
dc.date.accessioned	2024-05-20T03:30:12Z
dc.date.available	2023-09-12
dc.date.available	2024-05-20T03:30:12Z
dc.date.issued	2023-10
dc.identifier.citation	Cancer Med, 2023, 12, (19), pp. 20081-20093
dc.identifier.issn	2045-7634
dc.identifier.issn	2045-7634
dc.identifier.uri	http://hdl.handle.net/10453/179050
dc.description.abstract	BACKGROUND: Given advances in the management of cancer, it is increasingly important for clinicians to appropriately manage the risk of cardiovascular disease (CVD) among cancer survivors. It is unclear whether CVD risk is increased among cancer survivors overall, and there is inconsistency in evidence to date about CVD incidence and mortality by cancer type. METHODS: Patients aged 30-74 years entered an open cohort study at the time of first CVD risk assessment, between 2004 and 2018, in primary care in New Zealand. Patients with established CVD or cancer within 2 years prior to study entry were excluded. Cancer diagnosis (1995-2016) was determined from a national cancer registry. Cause-specific hazard models were used to examine the association between history of cancer and two outcomes: (1) CVD-related hospitalization and/or death and (2) CVD death. RESULTS: The study included 446,384 patients, of whom 14,263 (3.2%) were cancer survivors. Risk of CVD hospitalization and/or death was increased among cancer survivors compared with patients without cancer at cohort entry (multivariable-adjusted hazard ratio, mHR, 1.11, 95% CI 1.05-1.18), more so for CVD death (1.31, 1.14-1.52). Risk of CVD hospitalization and/or death was increased in patients with myeloma (2.66, 1.60-4.42), lung cancer (2.19, 1.48-3.24) and non-Hodgkin lymphoma (1.90, 1.42-2.54), but not for some cancers (e.g., colorectal, 0.87, 0.71-1.06). Risk of CVD death was increased in several cancer types including melanoma (1.73, 1.25-2.38) and breast cancer (1.56, 1.16-2.11). CONCLUSION: CVD risk management needs to be prioritized among cancer survivors overall, and particularly in those with myeloma, lung cancer and non-Hodgkin lymphoma given consistent evidence of increased risk.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	WILEY
dc.relation.ispartof	Cancer Med
dc.relation.isbasedon	10.1002/cam4.6580
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	0601 Biochemistry and Cell Biology, 1112 Oncology and Carcinogenesis
dc.subject.classification	3211 Oncology and carcinogenesis
dc.subject.mesh	Humans
dc.subject.mesh	Cardiovascular Diseases
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Cancer Survivors
dc.subject.mesh	Multiple Myeloma
dc.subject.mesh	New Zealand
dc.subject.mesh	Lymphoma, Non-Hodgkin
dc.subject.mesh	Lung Neoplasms
dc.subject.mesh	Primary Health Care
dc.subject.mesh	Risk Factors
dc.subject.mesh	Humans
dc.subject.mesh	Lymphoma, Non-Hodgkin
dc.subject.mesh	Multiple Myeloma
dc.subject.mesh	Lung Neoplasms
dc.subject.mesh	Cardiovascular Diseases
dc.subject.mesh	Risk Factors
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Primary Health Care
dc.subject.mesh	New Zealand
dc.subject.mesh	Cancer Survivors
dc.subject.mesh	Humans
dc.subject.mesh	Cardiovascular Diseases
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Cancer Survivors
dc.subject.mesh	Multiple Myeloma
dc.subject.mesh	New Zealand
dc.subject.mesh	Lymphoma, Non-Hodgkin
dc.subject.mesh	Lung Neoplasms
dc.subject.mesh	Primary Health Care
dc.subject.mesh	Risk Factors
dc.title	Risk of cardiovascular disease in cancer survivors: A cohort study of 446,384 New Zealand primary care patients.
dc.type	Journal Article
utslib.citation.volume	12
utslib.location.activity	United States
utslib.for	0601 Biochemistry and Cell Biology
utslib.for	1112 Oncology and Carcinogenesis
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
dc.date.updated	2024-05-20T03:30:11Z
pubs.issue	19
pubs.publication-status	Published
pubs.volume	12
utslib.citation.issue	19

Abstract:

BACKGROUND: Given advances in the management of cancer, it is increasingly important for clinicians to appropriately manage the risk of cardiovascular disease (CVD) among cancer survivors. It is unclear whether CVD risk is increased among cancer survivors overall, and there is inconsistency in evidence to date about CVD incidence and mortality by cancer type. METHODS: Patients aged 30-74 years entered an open cohort study at the time of first CVD risk assessment, between 2004 and 2018, in primary care in New Zealand. Patients with established CVD or cancer within 2 years prior to study entry were excluded. Cancer diagnosis (1995-2016) was determined from a national cancer registry. Cause-specific hazard models were used to examine the association between history of cancer and two outcomes: (1) CVD-related hospitalization and/or death and (2) CVD death. RESULTS: The study included 446,384 patients, of whom 14,263 (3.2%) were cancer survivors. Risk of CVD hospitalization and/or death was increased among cancer survivors compared with patients without cancer at cohort entry (multivariable-adjusted hazard ratio, mHR, 1.11, 95% CI 1.05-1.18), more so for CVD death (1.31, 1.14-1.52). Risk of CVD hospitalization and/or death was increased in patients with myeloma (2.66, 1.60-4.42), lung cancer (2.19, 1.48-3.24) and non-Hodgkin lymphoma (1.90, 1.42-2.54), but not for some cancers (e.g., colorectal, 0.87, 0.71-1.06). Risk of CVD death was increased in several cancer types including melanoma (1.73, 1.25-2.38) and breast cancer (1.56, 1.16-2.11). CONCLUSION: CVD risk management needs to be prioritized among cancer survivors overall, and particularly in those with myeloma, lung cancer and non-Hodgkin lymphoma given consistent evidence of increased risk.

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http://hdl.handle.net/10453/179050