Age at cancer diagnosis may influence risk of heart disease death.

Abstract

The age of an individual when he or she is diagnosed with cancer may help to determine his or her risk of dying from heart disease according to the results of a study recently published in the journal Circulation.1 Among survivors of childhood cancer, breast cancer, and Hodgkin lymphoma, heart disease is known to be the leading cause of treatment-related, nontumor deaths; however, researchers note that, until now, the risk of cardiac mortality had not been comprehensively researched in a large population of teenage and young adult cancer survivors. The study's senior author, Mike Hawkins, DPhil, an epidemiology professor and director of the Centre for Childhood Cancer Studies at the University of Birmingham in England, notes that the knowledge gleaned from this study will help clinicians focus the most intensive follow-up care on those most at risk, and also will help survivors become more aware of long-term risks associated with specific treatments. The biggest effect related to the age at diagnosis was seen in survivors of Hodgkin lymphoma: 6.9% of those diagnosed between the ages of 15 and 19 years died of heart disease by the age of 55 years, whereas 2% of those diagnosed between the ages of 35 and 39 years did. In the general population, fewer than 1% of people of the same age would be expected to die. Findings further showed that survivors of Hodgkin lymphoma had a 3.8 times higher risk of death from heart disease than expected in people of the same age and sex in the general population. Among survivors of Hodgkin lymphoma older than 60 years, almost 28% of the total excess number of deaths were attributed to heart disease, the study found. Researchers also found that survivors of other types of cancer, such as leukemia, genitourinary cancer, lung cancer, and breast cancer, who were diagnosed as teens or young adults showed a higher than expected risk of death from heart disease. They note, however, that the study did not include detailed information on exposures to cancer treatments such as radiotherapy and chemotherapy. Dr. Hawkins says teenage and young adult survivors of cancer are internationally acknowledged to be an understudied population.