Survivors of Uterine Cancer Have Increased Risk of Heart Disease Years After Treatment Has Ended


Key Points

  • Endometrial cancer survivors were nearly 50% more likely to be diagnosed with cardiac dysrhythmias and congestive heart failure than individuals in the general population at both 1 to 5 years and more than 5 to 10 following their cancer diagnosis.
  • Increasing monitoring for cardiovascular diseases may be important for survivors of endometrial cancer for 10 years after their cancer diagnosis.

A large population-based study by Soisson et al examining the long-term cardiovascular outcomes among survivors of endometrial cancer has found that women were at higher risk for a number of cardiovascular risks, including hypertension; diseases of the arteries, arterioles, and capillaries; diseases of the veins and lymphatics; and diseases of the heart at 1 to 5 years following their diagnosis, with some risk persisting up to 10 years later. Increasing monitoring for cardiovascular diseases may be important for survivors of endometrial cancer for 10 years after their cancer diagnosis, according to the study. The study is published in the Journal of the National Cancer Institute.

According to the American Cancer Society, endometrial cancer is the most common cancer of the female reproductive organs, accounting for over 63,000 new cases each year. While the cancer kills more than 11,000 women annually, there are more than 600,000 survivors of endometrial cancer in the United States. Several studies have shown that cardiovascular disease is the leading cause of death among endometrial cancer survivors.

Study Methodology

The researchers analyzed data from a cohort of 2,648 survivors of endometrial cancer diagnosed between 1997 and 2012 identified in the SEER Utah Cancer Registry, and 10,503 age-matched women from the general population. Cardiovascular disease diagnoses were identified from electronic medical records and statewide ambulatory surgery and statewide inpatient data. Cox regression models were used to estimate hazard ratios (HRs) at 1 to 5 years after cancer diagnosis as well as more than 10 years after diagnosis. 

Study Results

The researchers found that between 1 and 5 years after diagnosis, increased cardiovascular risks among endometrial cancer survivors were observed for phlebitis, thrombophlebitis, and thromboembolism (HR = 2.07, 99% confidence interval [CI] = 1.57–2.72); pulmonary heart disease (HR = 1.74, 99% CI = 1.26–2.40); and atrial fibrillation (HR = 1.50, 99% CI = 1.07–2.11). At more than 5 to 10 years, some elevated risk persisted for cardiovascular diseases.

Compared with patients who had surgery, patients who additionally had radiation therapy and/or chemotherapy were at increased risk for heart and circulatory system disorders between 1 and 5 years after cancer diagnosis. Older age and obesity were also risk factors for hypertension and heart disease among endometrial cancer survivors. 

“Endometrial cancer survivors in this cohort were at higher risk for a number of longer-term cardiovascular outcomes. Many of the conditions examined in this study have shared risk factors with endometrial cancer. But after adjusting for baseline [body mass index], baseline Charlson Comorbidity Index, and race, it is clear from these results that survivors of endometrial cancer in this cohort experienced a high burden of cardiovascular events. These results highlight the importance of placing greater emphasis on survivorship and that increased monitoring and risk management for cardiovascular disease for 10 years among endometrial cancer survivors is warranted,” concluded the study authors.

Mia Hashibe, PhD, Associate Professor in the Department of Family and Preventive Medicine at the Huntsman Cancer Institute, is the corresponding author of this study. 

Funding for this study was provided by the National Institutes of Health, the University of Utah, and the Utah State Department of Health.

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®.