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Impact of Cardiovascular Diseases on Mortality in Gastric Cancer Patients with Preexisting Chronic Disease
Kyu-Tae Han1, Dong Wook Kim2, Woorim Kim3
1Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
Insights
Gastric cancer patients with common chronic diseases like hypertension or diabetes face higher mortality if diagnosed with cardiovascular disease (CVD) shortly before their cancer diagnosis. Managing CVD in these patients is crucial for improving survival outcomes.
Area of Science:
- Oncology
- Cardiology
- Public Health
Background:
- Chronic diseases and cardiovascular diseases (CVD) are independently associated with adverse cancer outcomes.
- Gastric cancer patients with pre-existing hypertension, diabetes, or dyslipidemia represent a vulnerable population.
Purpose of the Study:
- To determine if gastric cancer patients with hypertension, diabetes, or dyslipidemia have increased mortality when diagnosed with CVD within one year prior to their cancer diagnosis.
- Investigate the impact of recent CVD incidence on 5-year mortality in this specific patient group.
Main Methods:
- Utilized data from the National Health Insurance database (2002-2019).
- Included gastric cancer patients with hypertension, diabetes, or dyslipidemia.
- Employed survival analysis with Cox proportional hazards models to assess 5-year mortality.
- Conducted subgroup analyses based on age, economic status, and initial treatment hospital type.
Main Results:
- A total of 6458 patients were analyzed; 32.7% had a CVD diagnosis within the preceding year.
- Patients diagnosed with CVD within one year before gastric cancer diagnosis exhibited a significantly higher risk of 5-year mortality (HR 1.259, 95% CI 1.138-1.394).
- The increased mortality risk was more pronounced in patients of low economic status and those initially treated at general hospitals.
Conclusions:
- Recent CVD diagnosis in gastric cancer patients with chronic conditions (hypertension, diabetes, dyslipidemia) is linked to elevated 5-year mortality.
- Highlights the critical need for integrated management of chronic diseases and cardiovascular health in cancer patients.
- Emphasizes proactive CVD risk assessment and management in gastric cancer patients with comorbidities.
Purpose:
Chronic diseases and cardiovascular diseases (CVD) have been independently linked to poorer cancer outcomes. This study investigated whether gastric cancer patients with hypertension, diabetes, or dyslipidemia have higher mortality if diagnosed with CVD in the past year before cancer diagnosis.
Materials And Methods:
Data were obtained from the National Health Insurance database for 2002 to 2019. The study population consisted of gastric cancer patients with hypertension, diabetes, or dyslipidemia. The outcome measure was 5-year mortality in relation to incident status of CVD within 1 year before cancer diagnosis. A survival analysis was conducted using the Cox proportional hazards model. Subgroup analysis was conducted according to age, economic status, and type of hospital first visited for cancer treatment.
Results:
Of a total of 6458 individuals, 2123 (32.7%) were diagnosed with CVDs in the past year before cancer diagnosis. Compared to participants without a history of CVD, those who were diagnosed with CVD showed a higher risk of 5-year mortality (hazard ratio 1.259, 95% confidence interval 1.138-1.394). The extent to which the mortality risk differed between those with and without CVD was greater for individuals of low economic status and in those receiving their initial cancer treatment in a general hospital.
Conclusion:
Patients with gastric cancer and hypertension, diabetes, or dyslipidemia diagnosed with CVD within 1 year before their cancer diagnosis had a higher mortality risk, emphasizing the importance of managing cancer patients with chronic disease and subsequent incidence of CVDs.
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