Temporal Trends in Cause-Specific Cardiovascular Disease Mortality Following Cancer Diagnosis

This study analyzed temporal trends in cardiovascular disease (CVD) mortality, stratified by disease type, cancer type, and demographic characteristics.

Individuals diagnosed with cancer between January 2016 and June 2020 were analyzed using data from the National Cancer Registry in Japan. Standardized mortality ratios (SMRs) were calculated by comparing observed CVD deaths among individuals with cancer to expected deaths in the age- and sex-matched general population. Outcomes included myocardial infarction, other heart diseases, ischemic stroke, hemorrhagic stroke, and all-cause CVD mortality. Multivariable Cox models were developed to estimate hazard ratios for the covariates.

The analysis included 4,711,540 individuals and 70,630 CVD deaths during the follow-up period. Across all outcomes, SMRs peaked 0-1 month after diagnosis (e.g., 2.35 for all CVDs) and declined sharply by 6 months (e.g., 1.18 for all CVDs). For several CVD outcomes, a secondary increase in SMRs was observed at approximately 37-48 months (e.g., 1.30 for all CVDs). Although the number of deaths for each CVD was higher among older individuals, SMRs were greater in younger age groups. The five most common cancers accounted for approximately half of all deaths and showed similar temporal trends. Cox models achieved moderate predictive accuracy, and adjusted hazard ratios were higher for regional metastasis, distant metastasis, and unknown/other categories than for localized tumors.

This study revealed detailed temporal patterns of CVD mortality following cancer diagnosis, particularly during acute phases.