Survivors of Adolescent and Young Adult Cancer May Be at Increased Risk of Cardiovascular Disease


Key Points

  • Adolescent and young adult cancer survivors are at increased risk of cardiovascular disease, according to a retrospective study at Kaiser Permanente Southern California.
  • Survivors with vs without cardiovascular disease have an increased mortality risk.

Survivors of adolescent and young adult cancer were at a greater than twofold increased risk for cardiovascular disease than their counterparts without cancer, according to a study reported in the Journal of Clinical Oncology by Chao et al.

Study Details

The study involved data from a retrospective cohort of 5,673 2-year survivors of adolescent and young adult cancer who were diagnosed between the ages of 15 to 39 years between 1998 and 2009 at Kaiser Permanente Southern California. A comparison group without cancer (n = 57,617) was matched 10:1 to cancer survivors for age, sex, Kaiser Permanente membership, and calendar year.

Patients were followed through December 2012 for coronary artery disease, heart failure, and stroke. Risk of cardiovascular disease was adjusted for cardiovascular risk factors (ie, diabetes, hypertension, and dyslipidemia), ethnicity, smoking, and overweight/obesity.

Risk of Cardiovascular Disease

Cancer survivors were at a significantly increased risk of cardiovascular disease (adjusted incidence rate ratio [IRR] = 2.37, 95% confidence interval [CI] = 1.93–2.93). The highest risk was observed among survivors of leukemia (IRR = 4.23, 95% CI = 1.73–10.31) and breast cancer (IRR = 3.63, 95% CI = 2.41–5.47). The presence of any cardiovascular disease risk factor increased the risk of cardiovascular disease in cancer survivors. Overall mortality risk was significantly greater in survivors with vs without cardiovascular disease (hazard ratio = 10.9, 95% CI = 8.1–14.8).

The investigators concluded: “Survivors of adolescent and young adult cancer are at increased risk for developing cardiovascular disease. Survival after cardiovascular disease onset is compromised, and [cardiovascular risk factors] are independent modifiers of cardiovascular disease risk. These data form the basis for identifying high-risk individuals and proactive management of [cardiovascular risk factors].”

The study was supported by the American Cancer Society.

Chun Chao, PhD, of Kaiser Permanente Southern California, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.