Abstract
We aimed to assess which lifestyle risk behaviors have the greatest influence on the risk of cardiovascular disease in cancer survivors and which of these behaviors are most prominently clustered in cancer survivors, using logistic regression and association rule mining (ARM). We analyzed a consecutive series of 897 cancer survivors from the Korean National Health and Nutritional Exam Survey (2012–2016). Cardiovascular disease risks were assessed using the atherosclerotic cardiovascular disease score (ASCVDs). We classified participants as being in a low-risk group if their calculated ASCVDs was less than 10% and as being in a high-risk group if their score was 10% or higher. We used association rule mining to analyze patterns of lifestyle risk behaviors by ASCVDs risk group, based upon public health recommendations described in the Alameda 7 health behaviors (current smoking, heavy drinking, physical inactivity, obesity, breakfast skipping, frequent snacking, and suboptimal sleep duration). Forty-two percent of cancer survivors had a high ASCVD. Current smoking (common odds ratio, 11.19; 95% confidence interval, 3.66–34.20, p < 0.001) and obesity (common odds ratio, 2.67; 95% confidence interval, 1.40–5.08, p < 0.001) were significant predictors of high ASCVD in cancer survivors within a multivariate model. In ARM analysis, current smoking and obesity were identified as important lifestyle risk behaviors in cancer survivors. In addition, various lifestyle risk behaviors co-occurred with smoking in male cancer survivors.
Highlights
The number of cancer survivors is rapidly increasing worldwide due to improvements in early diagnosis and treatment of cancer [1]
Several recent studies have reported that cancer survivors have a high risk of cardiovascular disease [3], and cancer survivors who are at risk of cardiovascular disease have a significantly higher mortality rate than those who do not have cardiovascular risk [4,5]
Current smoking the important behaviors in cancerfor survivors with high risk
Summary
The number of cancer survivors is rapidly increasing worldwide due to improvements in early diagnosis and treatment of cancer [1]. Due to these advances in cancer diagnosis and treatment, deaths due to treatment complications and other chronic diseases are gradually increasing in cancer patients [2]. Several recent studies have reported that cancer survivors have a high risk of cardiovascular disease [3], and cancer survivors who are at risk of cardiovascular disease have a significantly higher mortality rate than those who do not have cardiovascular risk [4,5]. Cardiotoxic drug treatments such as anthracycline [9], paclitaxel, and trastuzumab [10], and mediastinal radiation therapy can directly damage the cardiovascular system [11]
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