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Published on: January 12, 2017
Cardiovascular Screening and Lipid Management in Breast Cancer Survivors
S Tucker Price1, Lisa D Mims1, Marty S Player1
1From the Department of Family Medicine, Medical University of South Carolina, Charleston, SC (STP, LDM, MSP, CB, SP, VAD); Medical University of South Carolina Department of Psychiatry and Behavioral Sciences, Charleston, SC (CHH).
Insights
Breast cancer survivors with primary care show better cholesterol screening and statin use. This improves management of cardiovascular disease (CVD) risk factors in this high-risk population.
Area of Science:
- Oncology
- Cardiology
- Primary Care Medicine
Background:
- Cardiovascular disease (CVD) is the primary cause of mortality for breast cancer (BC) survivors.
- BC survivors face elevated CVD risks due to prevalent risk factors.
- Limited data exist on CVD screening and lipid management for BC survivors in primary care.
Purpose of the Study:
- To evaluate cardiovascular screening and lipid management practices in breast cancer survivors within primary care settings.
- To compare these practices between BC survivors and matched controls.
Main Methods:
- Retrospective case-control study involving 105 BC survivors and 210 matched controls.
- Data collected via chart review, focusing on CVD screening and lipid management.
- Controls matched for age and comorbidities (diabetes, hypertension, hyperlipidemia).
Main Results:
- BC survivors exhibited higher rates of cholesterol screening (88% vs. 70%) and statin prescriptions (63% vs. 40%) when indicated.
- Older survivors and those with established primary care were more likely to receive cholesterol screening.
- African American survivors had higher rates of hypertension and overweight/obesity compared to White survivors.
Conclusions:
- Established primary care access is associated with improved cholesterol screening and statin therapy for BC survivors.
- This suggests better management of chronic disease risks in this population.
- Further research may be needed to address disparities in risk factors among different racial groups.
Background:
Cardiovascular disease (CVD) is the leading cause of death among breast cancer (BC) survivors. BC survivors are at increased risk of CVD due to a higher prevalence of risk factors. Current data are limited on the cardiovascular screening practices and lipid management in this population in primary care settings.
Methods:
A retrospective case control study was performed with 105 BC survivors and 210 matched controls (based on age and medical comorbidities of diabetes, hypertension, and hyperlipidemia). BC survivors were established with primary care practices within a large academic institution and had completed primary cancer treatment. Data on screening for CVD and lipid management were collected via a retrospective chart review.
Results:
The average BC survivor was 63 years old, with 9 years since diagnosis. Compared with matched controls, BC survivors had more cholesterol screening (88% vs 70%, P < .001) and active statin prescriptions (63% vs 40%, P < .05) if indicated by the Atherosclerotic Cardiovascular Disease Calculator. There were no differences in CVD screening in White and African American BC survivors. However, African American BC survivors were more likely to have hypertension (P < .01) and have a body mass index in the overweight and obese category (P < .001) than White BC survivors. Older BC survivors were more likely to receive cholesterol screening.
Discussion:
This study demonstrates that BC survivors who have an established primary care provider have improved cholesterol screening and statin therapy based on their risk of developing chronic diseases.
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