[SEMERGEN Position Statement on the management of the Oncologic Patient: Comprehensive Approach to Cardiotoxicity in...

The sustained improvement in cancer survival has highlighted the growing impact of cardiovascular toxicity related to anticancer therapies, which has become a leading cause of non-cancer morbidity and mortality. This position statement aims to provide a practical and standardized framework for the comprehensive management of cardiotoxicity in oncology patients from the perspective of Primary Care (PC) in Spain, acknowledging its pivotal role in prevention, early detection, risk stratification, and long-term follow-up. The document reviews the main forms of cardiovascular toxicity associated with systemic anticancer therapies, as well as local treatments such as thoracic radiotherapy, incorporating current definitions and recommendations from European and international guidelines. A structured model based on the oncology care continuum is proposed, encompassing the initial phase, active treatment, and survivorship, allowing cardiovascular surveillance to be tailored according to baseline risk, type of treatment, and clinical evolution. Special emphasis is placed on early cardiovascular risk assessment, proactive optimization of cardiovascular risk factors and comorbidities, and the establishment of clear referral and coordination pathways between PC, Oncology, Hematology and Cardiology. The central role of PC in the follow-up of long-term cancer survivors is also highlighted, as this growing population remains at risk of late cardiovascular complications that may persist or increase over time. This position statement seeks to promote coordinated, equitable, and patient-centered care, reducing clinical variability and improving cardiovascular outcomes and quality of life for oncology patients within the National Health System.