mHealth technologies in research studying cardiovascular health in cancer: A systematic review

Cancer survivors face an increased risk of cardiovascular disease (CVD) due to treatment-related toxicity, lifestyle factors, and comorbidities. Addressing CV health is crucial for improving quality of life and long-term outcomes. The American Heart Association's Life's Essential 8 framework highlights modifiable determinants of CV health, emphasizing early detection and monitoring. Mobile health (mHealth) technologies, such as wearables and smartphone apps, offer continuous tracking, yet their applications in cancer survivorship remain unclear. This review systematically characterizes the types of mHealth technologies used to monitor CV health in cancer survivors, focusing on the specific data collected (major adverse CV events, CV risk factors, and surrogate endpoints) and the use of active versus passive collection methods. A systematic search of PubMed, Scopus, Embase, and Web of Science identified studies published between January 1, 2016, and June 13, 2024. Eligible studies included observational and interventional designs assessing at least one CV outcome using mHealth. Data were extracted on design, technology type, and outcomes. Risk of bias was evaluated using the Cochrane RoB-2 and ROBINS-I tools. Fourteen studies (13 interventional, one observational) met criteria. Physical activity was the most monitored risk factor, followed by HR. The most common technologies were mobile apps and commercial wearables. Passive methods typically captured PA and HR, while active methods captured PA, symptom tracking, and diet. A key finding was the lack of integration with electronic medical records, highlighting a gap in clinical implementation. mHealth provides scalable tools to track CV health indicators in cancer survivors. Findings highlight the potential to support practice by enabling remote oversight of risk-reducing behaviors and guiding lifestyle interventions. However, we also identified gaps, including the underutilization of biomarkers (e.g., HRV) and the lack of integration with electronic records. Future research must address these gaps to translate real-time data into clinical insights and optimize survivorship care.