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Heart Disease Mortality in Cancer Survivors: A Population-Based Study in Japan
Yasufumi Gon1,2, Ling Zha3, Tsutomu Sasaki1
1Department of Neurology Osaka University Graduate School of Medicine, Suita Osaka Japan.
Journal of the American Heart Association
|November 28, 2023
Summary
Cancer survivors face a significantly higher risk of fatal heart disease compared to the general population. This risk, particularly for ischemic heart disease and heart failure, has shown a recent decline.
Area of Science:
- Cardiovascular epidemiology
- Oncology
- Public health
Background:
- Limited data exists regarding cardiovascular-related mortality risks in cancer patients.
- Understanding non-cancer mortality in cancer survivors is crucial for comprehensive care.
Purpose of the Study:
- To investigate the risk of fatal heart disease among cancer patients in Japan.
- To compare cardiovascular mortality in cancer patients versus the general population.
- To analyze trends and risk factors for heart disease mortality in cancer survivors.
Main Methods:
- Retrospective cohort study utilizing the Osaka Cancer Registry and Japanese vital statistics (1985-2013).
- Analysis of causes of death, calculating standardized mortality ratios (SMRs) and using Fine and Gray competing risk models.
- Inclusion of 682,886 cancer patients, with 335,635 deaths analyzed.
Main Results:
- Heart disease was the leading cause of non-cancer death (10,686 cases).
- Overall SMR for heart disease was 2.80; specific SMRs for ischemic heart disease (3.26), heart failure (2.69), and hypertensive disease (5.97) were elevated.
- Risk of fatal heart disease increased post-cancer diagnosis; men had a higher risk (SHR=1.08). Risk has decreased in recent years.
Conclusions:
- Cancer survivors exhibit a substantially higher risk of fatal heart disease compared to the general population.
- Specific heart conditions like hypertensive disease pose a disproportionately higher risk.
- While risks remain elevated, recent trends indicate a decrease in fatal heart disease among cancer survivors.
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