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Age-specific cardiovascular disease-related mortality among patients with major gastrointestinal cancers: A SEER
1Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute, Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan, China.
Insights
Age significantly increases the risk of cardiovascular disease (CVD) mortality in patients with major gastrointestinal cancers. Older individuals face substantially higher CVD-related mortality rates compared to younger patients.
Area of Science:
- Oncology
- Cardiovascular Medicine
- Epidemiology
Background:
- Age is a known risk factor for cardiovascular disease (CVD) mortality.
- Limited research exists on the specific relationship between age and CVD mortality in major gastrointestinal cancers.
- Understanding this link is crucial for patient management and risk stratification.
Purpose of the Study:
- To investigate the association between age and cardiovascular disease (CVD)-related mortality in patients diagnosed with major gastrointestinal cancers.
- To quantify the risk of CVD mortality across different age groups within these cancer populations.
- To identify potential non-linear relationships between age at diagnosis and CVD mortality.
Main Methods:
- Retrospective cohort study utilizing data from the Surveillance, Epidemiology and End Results (SEER) Registry (2000-2015).
- Inclusion of patients with colorectal, pancreatic, hepatocellular, gastric, and esophageal cancers.
- Statistical analyses included standardized mortality ratio (SMR), competing risk regression, and restricted cubic spline (RCS) models.
Main Results:
- Analysis of 576,713 patients with major gastrointestinal cancers.
- Patients with gastrointestinal cancers exhibited higher CVD-related mortality than the general U.S. population.
- Significantly elevated adjusted sub-hazard ratios for CVD mortality were observed in middle-aged and older patients across all studied cancer types, with older patients showing markedly higher risks.
Conclusions:
- Age is confirmed as a significant risk factor for cardiovascular disease (CVD)-related mortality in patients with major gastrointestinal cancers.
- The study highlights a non-linear relationship between age at diagnosis and CVD mortality for colorectal, pancreatic, and esophageal cancers.
- Findings underscore the importance of considering age-related cardiovascular risks in the oncological care of gastrointestinal cancer patients.
Background:
Studies have reported age as a risk factor for cardiovascular disease (CVD)-related mortality; however, only a few studies have focused on the relationship between age and CVD-related mortality, especially among major gastrointestinal cancers.
Method:
The present retrospective cohort enrolled patients with colorectal, pancreatic, hepatocellular, gastric, and esophageal cancer between 2000 to 2015 from the Surveillance, Epidemiology and End Results Registry (SEER). Standardized mortality ratio (SMR), competing risk regression, and restricted cubic spline (RCS) analyses were used in our study.
Results:
We analyzed 576,713 patients with major gastrointestinal cancers (327,800 patients with colorectal cancer, 93,310 with pancreatic cancer, 69,757 with hepatocellular cancer, 52,024 with gastric cancer, and 33,822 with esophageal cancer). Overall, CVD-related mortality gradually decreased every year, and the majority were older patients. All cancer patients had a higher CVD-related mortality rate than the general U.S.
Population:
The adjusted sub-hazard ratios for middle-aged with colorectal cancer, pancreatic cancer, hepatocellular cancer, gastric cancer, and esophageal cancer were 2.55 (95% CI: 2.15-3.03), 1.77 (95% CI: 1.06-2.97), 2.64 (95% CI: 1.60-4.36), 2.15 (95% CI: 1.32-3.51), and 2.28 (95% CI: 1.17-4.44), respectively. The adjusted sub-hazard ratios for older patients with colorectal cancer, pancreatic cancer, hepatocellular cancer, gastric cancer, and esophageal cancer were 11.23 (95% CI: 9.50-13.27), 4.05 (95% CI: 2.46-6.66), 4.47 (95% CI: 2.72-7.35), 7.16 (95% CI: 4.49-11.41), and 4.40 (95% CI: 2.28-8.48), respectively. A non-linear relationship between age at diagnosis and CVD-related mortality was found in colorectal cancer, pancreatic cancer, and esophageal cancer; their reference ages were 67, 69, and 66 years old, respectively.
Conclusion:
This study demonstrated that age was a risk factor for CVD-related mortality among major gastrointestinal cancers.
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