Abstract 4242: Ethnic disparities in the risk of cardiac death following cancer diagnosis: A population-based study

Abstract

Abstract Background: Cancer-related cardiac complications and mortality have been well studied. However, the disparities among racial and ethnic groups have not been addressed on a large scale. In this study, we aimed to investigate the racial and ethnic disparities associated with cardiac death in cancer patients. Methods: Data were collected from The Surveillance, Epidemiology and End-Results program of the National Cancer Institute. We defined an "event" as death due to a cardiac cause within ten years after cancer diagnosis, and observed patients who experienced the event during that period. Then, we calculated the Observed/Expected (O/E) ratio and the excess risk per 10,000 person-years to estimate the change of risk following the diagnosis in different ethnicities, when compared to the general population. Results: We reviewed 4,671,989 cancer patients, of whom 163,255 died due to a cardiac cause within the ten years following cancer diagnosis. The overall risk of cardiac death increased significantly in this period with an O/E ratio of 1.16 and an excess risk of 11.66 per 10,000. The sample was divided into 2 groups: Whites with a total O/E ratio of 1.11, and non-Whites with a total O/E ratio of 1.38. When examined for the risk in the first 5 years after diagnosis, Whites and non-Whites demonstrated significant increase in the risk with O/E of 1.12 and 1.39, respectively. However, when examined for the long-term risk more than 5 years after diagnosis, only non-Whites had a significant increase with an O/E of 1.21, while Whites with a cancer diagnosis had the same risk of cardiac death as Whites without cancer diagnosis with an O/E of 1.00. The sample was then further subdivided according to ethnicity into non-Hispanic Whites, Blacks, American Indians (or Alaska natives), Asians (or Pacific islanders), and Hispanics. All groups showed a significantly increased risk of cardiac death following a cancer diagnosis (O/E=1.13, 1.36, 2.33, 1.44, and 1.05, respectively). Conclusion: Non-White patients with a prior cancer diagnosis had a significantly higher long-term risk of cardiac death compared to noncancer patients. Accordingly, careful attention should be paid to the cardiovascular status assessment of those patients to mitigate the added risk of cardiac mortality due to cancer-related morbidities. Further studies are warranted to determine why cardiac event risk increases at a discrepantly higher rate in minority patients with a cancer diagnosis. Citation Format: Mohamed M. Gad, Anas M. Saad, Muneer J. Al-Husseini, Abdelrahman I. Abushouk, Haitham M. Ahmed. Ethnic disparities in the risk of cardiac death following cancer diagnosis: A population-based study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4242.