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Long-term Cardiovascular Outcomes Among Endometrial Cancer Survivors in a Large, Population-Based Cohort Study.

Authors :
Soisson, Sean
Ganz, Patricia A
Gaffney, David
Rowe, Kerry
Snyder, John
Wan, Yuan
Deshmukh, Vikrant
Newman, Mike
Fraser, Alison
Smith, Ken
Herget, Kimberly
Hanson, Heidi A
Wu, Yelena P
Stanford, Joseph
Al-Sarray, Ali
Werner, Theresa L
Setiawan, Veronica W
Hashibe, Mia
Source :
JNCI: Journal of the National Cancer Institute; Dec2018, Vol. 110 Issue 12, p1342-1351, 10p, 6 Charts, 1 Graph
Publication Year :
2018

Abstract

<bold>Background: </bold>Endometrial cancer is the second most common cancer among female cancer survivors in the United States. Cardiovascular disease is the leading cause of death among endometrial cancer survivors. Studies that examine long-term cardiovascular outcomes among endometrial cancer survivors are critical.<bold>Methods: </bold>Cohorts of 2648 endometrial cancer survivors diagnosed between 1997 and 2012 and 10 503 age-matched women from the general population were identified. 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 one to five years, more than five to 10 years, and more than 10 years after cancer diagnosis.<bold>Results: </bold>Between one and five 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 to 2.72), pulmonary heart disease (HR = 1.74, 99% CI = 1.26 to 2.40), and atrial fibrillation (HR = 1.50, 99% CI = 1.07 to 2.11). At more than five 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 one and five years after cancer diagnosis. Older age and obesity were also risk factors for hypertension and heart disease among endometrial cancer survivors.<bold>Conclusions: </bold>Endometrial cancer survivors are at higher risk for various adverse long-term cardiovascular outcomes compared with women from the general population. This study suggests that increased monitoring for cardiovascular diseases may be necessary for endometrial cancer patients for 10 years after cancer diagnosis. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00278874
Volume :
110
Issue :
12
Database :
Complementary Index
Journal :
JNCI: Journal of the National Cancer Institute
Publication Type :
Academic Journal
Accession number :
133601194
Full Text :
https://doi.org/10.1093/jnci/djy070