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Specific Cardiovascular Mortality in Cancer Survivors: A Nationwide Population-Based Cohort Study in Japan
Yasufumi Gon1,2,3, Ling Zha4, Tomohiro Kawano1
1Department of Neurology Osaka University Graduate School of Medicine Osaka Japan.
Insights
Cancer survivors face a significantly higher risk of cardiovascular disease (CVD) mortality. This risk is particularly elevated for nonlymphoid hematologic malignancies and varies by specific CVD and cancer type.
Area of Science:
- Oncology
- Cardiovascular Medicine
- Epidemiology
Background:
- Growing cancer survivorship necessitates understanding long-term health risks.
- Cardiovascular disease (CVD) is a significant concern for cancer survivors.
- This study investigates CVD mortality in cancer patients versus the general population.
Purpose of the Study:
- To compare cardiovascular disease (CVD) mortality rates in cancer patients and the general population.
- To analyze CVD mortality risk across specific cardiovascular conditions.
- To identify cancer types with the highest associated CVD mortality.
Main Methods:
- Nationwide population-based cohort study using Japanese National Cancer Registry data.
- Inclusion of patients diagnosed with cancer between January 2016 and December 2019.
- Calculation of standardized mortality ratios (SMRs) to compare CVD mortality risks.
Main Results:
- Cancer patients exhibited a 2.39-fold higher risk of cardiovascular death compared to the general population.
- Nonlymphoid hematologic malignancies showed the highest overall CVD mortality SMR (4.32).
- Specific CVDs demonstrated varied risks: ischemic heart disease and heart failure were highest in nonlymphoid hematologic malignancies; aortic dissection, ischemic stroke, and hemorrhagic stroke risks were highest in laryngeal, pancreatic, and liver cancers, respectively.
Conclusions:
- Cancer patients face a substantially increased risk of cardiovascular disease mortality.
- Nonlymphoid hematologic malignancies are associated with the most prominent CVD mortality.
- CVD mortality risk is highly dependent on both the type of cancer and the specific cardiovascular condition.
Background:
Improvements in cancer survivorship have led to concern about cardiovascular disease (CVD) among cancer survivors. This study aimed to investigate CVD mortality in patients with cancer compared with the general population, with a focus on specific CVDs including ischemic heart disease, heart failure, aortic dissection, ischemic stroke, and hemorrhagic stroke.
Methods:
This nationwide population-based cohort study used data from the National Cancer Registry in Japan. Patients diagnosed with cancer between January 2016 and December 2019 were included. Standardized mortality ratios (SMRs) and their 95% CIs were calculated to compare the risk of CVD mortality between patients with cancer and the general population. The SMRs were also computed for each specific CVD.
Results:
The study included 3 972 603 patients, representing 6 212 672 person-years of follow-up. Patients with cancer had a 2.39-fold higher risk of cardiovascular death compared with the general population. The SMR was highest for nonlymphoid hematologic malignancies (4.32 [95% CI, 4.15-4.50]). The mortality risk varied across specific types of CVD. Nonlymphoid hematologic malignancies had the highest SMRs for ischemic heart disease (3.15 [95% CI, 2.87-3.45]) and heart failure (7.65 [95% CI, 7.07-8.27]). The SMR for aortic dissection, ischemic stroke, and hemorrhagic stroke were highest for laryngeal (3.31 [95% CI, 2.29-4.79]), pancreatic (5.39 [95% CI, 4.79-6.05]), and liver (3.75 [95% CI, 3.36-4.18]) cancers, respectively.
Conclusions:
Patients with cancer had a higher CVD mortality risk, which was prominent in nonlymphoid hematologic malignancies. The mortality risk varied considerably by cancer type and specific CVD type.
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