Incidence of cardiovascular disease up to 13 year after cancer diagnosis: A matched cohort study among 32 757 cancer survivors

• Published in: Cancer medicine (Malden, MA) MA), 2018-10, Vol.7 (10), p.4952-4963
• Main Authors: Schoormans, Dounya, Vissers, Pauline A. J., Herk‐Sukel, Myrthe P. P., Denollet, Johan, Pedersen, Susanne S., Dalton, Susanne O., Rottmann, Nina, Poll‐Franse, Lonneke
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Basal cell carcinoma; Breast; cancer survivors; Cancer Survivors - statistics & numerical data; Cancer therapies; cardiotoxic treatment; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Clinical Cancer Research; Cohort analysis; Cohort Studies; Colorectal carcinoma; Female; Follow-Up Studies; Gender; Health risk assessment; Humans; Incidence; Lung cancer; Male; matched cohort study; Menopause; Middle Aged; Neoplasms - classification; Neoplasms - epidemiology; Netherlands - epidemiology; Original Research; Prostate; Prostate cancer; Registries; Regression Analysis; Risk factors; Statistical analysis; Trachea; Young Adult
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.1754

We examined the incidence of cardiovascular disease (CVD) among 32 757 cancer survivors and age‐, gender‐, and geographically matched cancer‐free controls during a follow‐up period of 1‐13 years, and explored whetherCVD incidence differed by received cancer treatment, traditional cardiovascular risk factors, age, or gender. Adult 1‐year cancer survivors without a history ofCVD diagnosed with breast (n = 6762), prostate (n = 4504), non‐Hodgkin (n = 1553), Hodgkin (n = 173), lung and trachea (n = 2661), basal cell carcinoma (BCC; n = 12 476), and colorectal (n = 4628) cancer during 1999‐2011 were selected from the Netherlands Cancer Registry and matched to cancer‐free controls without a history ofCVD. Drug dispenses and hospitalizations from thePHARMO Database Network were used as proxy forCVD. Data were analyzed using Cox regression analyses. Prostate (HR: 1.17; 95%CI: 1.01‐1.35) and lung and trachea (HR: 1.48; 95%CI: 1.10‐1.97) cancer survivors had an increased risk for developingCVD compared to cancer‐free controls. This increased risk among lung and trachea cancer survivors remained statistically significant after including traditional cardiovascular risk factors and cancer treatment information (HR: 1.41; 95%CI: 1.06‐1.89). Among prostate cancer survivors, the increased risk of incidentCVD was limited to those who received hormones and those without traditional cardiovascular risk factors. Breast, non‐Hodgkin,BCC, and colorectal cancer survivors showed no increasedCVD risk compared to cancer‐free controls. There was an increased risk of incidentCVD among prostate, and lung and trachea cancer survivors compared to age‐, gender‐ and geographically matched cancer‐free controls. Studies including longer follow‐up periods are warranted to examine whether cancer survivors are at increased risk of long‐term incidentCVD. This large population‐based matched cohort study among 32 757 cancer survivors and age‐, gender, and geographically matched cancer‐free controls (1:1) during a follow‐up period of 1‐13 years showed an increased risk of incident CVD among prostate and lung and trachea cancer. For prostate cancer survivors, the increased risk of incident CVD was limited to those who received hormones and those without traditional cardiovascular risk factors. Breast, non‐Hodgkin, skin, and colorectal cancer survivors showed no increased CVD risk.