Abstract P576: Disparities in Cardiovascular Disease Outcomes Among Cancer Survivors in the United States: A Systematic Review

Abstract

Significance: Cardiovascular diseases (CVD) and cancer are leading causes of morbidity and mortality in the US; and cancer survivors are at increased risk for CVD. The risk for adverse CVD outcomes is not equitably distributed. Disparities exist; and some groups and/or communities that have been targeted for marginalization are more affected. Objective: To document known disparities in CVD outcomes among cancer survivors in the US and identify literature gaps to inform future studies. Methods: We used the Peer Review of Electronic Search Strategies (PRESS) guidelines and searched three databases: MEDLINE, PsycINFO, and Scopus on March 15 th , 2021. With a pre-defined PICOS framework, we used rayyan for articles screening and the PRISMA 2020 reporting guidelines. The Newcastle Ottawa Scale was used to assess the risk of bias. RAW Graphs were used to create alluvial charts. This review is registered with PROSPERO, ID # CRD42021236460. Results & Discussion: From 6,000 articles retrieved, 13 articles met our pre-defined inclusion criteria. All studies investigated racial and ethnic disparities. Gender, age at diagnosis, and cancer stage at diagnosis, and sensitivity C-reactive protein disparities were respectively investigated by one study. The most prevalent outcome investigated is CVD mortality, followed by CVD risk, CVD event, hypertension, and cardiotoxicity. Non-Hispanic Black survivors are at increased risk for all outcomes investigated which might suggest root causes of disparities into historical and structural racism. Conclusions & Implications: (1) Policy implication: There is an urgent need for stakeholders to work to eliminate root causes of disparities and all forms of injustice, by removing all systemic barriers that limit individuals’ access to essential resources needed to maintain health. (2) Clinical implication: Clinicians should increase screening for risk factors that exacerbate poor CVD outcomes. (3) Research implication: Researchers should enhance community partnerships and broaden their focus in investigating innovative approaches to reduce disparities and advance health equity and justice. Keywords: Disparities, cancer survivors, cardiovascular disease (CVD), cardio-oncology, racism, discrimination.