A recent large national study showed the mortality risk from cardiovascular disease differs considerably among cancer survivors by race/ethnicity and cancer types. The findings are being presented by Sung et al at the 2022 ASCO Annual Meeting (Abstract 12075).
In this study, lead author Hyuna Sung, PhD, Principal Scientist, Cancer Surveillance Research at the American Cancer Society, and colleagues used data from almost 3 million survivors of the top 23 cancers diagnosed between the ages of 20 and 64 during 2000 to 2018 obtained from 17 Surveillance, Epidemiology, and End Results registries. Risks for cardiovascular disease death among survivors relative to the general population were calculated using standardized mortality ratios (SMRs) in each racial/ethnic group: non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian. Among survivors, the risks were compared by race/ethnicity using cause-specific proportional hazards models for competing risks, controlling for year of diagnosis, age at diagnosis, sex, stage (when appropriate), and the first course of treatment receipt (surgery, radiotherapy, chemotherapy).
The results showed among 2,806,515 survivors (non-Hispanic White, 68%; non-Hispanic Black, 13%; Hispanic, 12%; non-Hispanic Asian or Pacific Islander, 7%; non-Hispanic American Indian, 0.5%), 57,883 cardiovascular disease deaths occurred during 6.4 person-years of mean follow-up. Cancer survivors overall were at increased risk of cardiovascular disease death compared with the general population, with an SMR of 1.76 among non-Hispanic Asian or Pacific Islander, 1.49 among non-Hispanic American Indian, 1.46 among Hispanic, 1.30 among non-Hispanic Black, and 1.13 among non-Hispanic White survivors. Compared with non-Hispanic White survivors, the adjusted hazard of cardiovascular disease death was statistically significantly higher among non-Hispanic Black survivors for all 23 cancers and among non-Hispanic American Indian survivors for 9 of 18 cancers but was statistically significantly lower among Hispanic survivors for 5 of 23 cancers and among non-Hispanic Asian or Pacific Islander survivors for 10 of 23 cancers, with no significant difference otherwise. The highest hazard ratios were among non-Hispanic Black survivors of melanoma; breast; pancreatic; and testicular cancers, whereas the lowest hazard ratios were among non-Hispanic Asian or Pacific Islander survivors of head and neck and cervical cancers and Hispanic survivors of cervical cancer.
Study authors highlighted the need for targeted prevention and surveillance in primary care and for future studies to identify factors that contribute to this variation to inform efforts toward mitigating risk.
Disclosures: For full disclosures of the study authors, visit coi.asco.org.
