Study: Cancer Survivors Have Higher Risk of Heart Disease

New research published in PLOS ONE has found that approximately 35% of Americans with a history of cancer had an elevated risk of cardiovascular disease in the next decade, compared to approximately 23% of people who never had cancer.

Investigators used a risk calculator that estimates a person’s 10-year chances of developing heart disease or stroke. They found that the average estimated 10-year risk for a cancer survivor was approximately 8%, compared to 5% for those without a history of cancer.

“We know that obesity, cancer, and cardiovascular disease share some common risk factors, and in addition to those shared risk factors, cancer patients also receive treatments including radiation and chemotherapy that can affect their cardiovascular health—we call that cardiotoxicity,” explained lead researcher Xiaochen Zhang, a PhD candidate in Ohio State’s College of Public Health, in a press release.

However, those risks are poorly understood and may be underestimated, Zhang said. According to the press release, he and his colleagues are urging steps to boost recognition of these risks among health care providers and their patients.

“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,” said study senior author Ashley Felix, PhD, in the 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.”

The investigative team used data from the National Health and Nutrition Examination Survey conducted by the Centers for Disease Control and Prevention. The nationally representative sample of people surveyed between 2007 and 2016 provides a good picture of the elevated risk for cancer survivors in the United States, the researchers said. For their analysis, the researchers analyzed data from 15,095 adults aged 40 to 79 years with no history of cardiovascular disease, almost 13% of whom reported a history of cancer.

The investigators noted their large study size, which allowed for analysis based on type of cancer and by age group. Survivors of testicular, prostate, bladder, and kidney cancers had a particularly high 10-year cardiovascular disease risk, as did those in their 60s.

When the investigators compared individual cardiovascular disease risk factors by cancer status, they found that older age, higher systolic blood pressure, and a personal history of diabetes were more common among cancer survivors. Despite these higher risks among older adults, Felix said clinicians should keep a close eye on younger cancer survivors as well. Almost 17 million Americans live with a cancer diagnosis, Felix said, and that number is expected to grow to 26 million by 2040.

“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,” Felix said.

The researchers also said there is a potential opportunity to develop a risk-assessment tool that takes cancer survivorship into account. This could allow for more precise assessments for that population.

REFERENCE

Cancer survivors face elevated heart disease risk, study finds [news release]. Ohio State University; March 17, 2021. https://news.osu.edu/cancer-survivors-face-elevated-heart-disease-risk-study-finds/. Accessed March 23, 2021.