Abstract
Cancer survivors are at an increased risk for cardiovascular disease (CVD). However, the association between particulate matter (PM) and CVD risk among cancer survivors (alive >5 years since diagnosis) is unclear. We investigated the risk of CVD among 40,899 cancer survivors within the Korean National Health Insurance Service database. Exposure to PM was determined by assessing yearly average PM levels obtained from the Air Korea database from 2008 to 2011. PMs with sizes <2.5 (PM2.5), <10 (PM10), or 2.5–10 (PM2.5–10) μm in diameter were compared, with each PM level exposure further divided into quintiles. Patients were followed up from January 2012 to date of CVD event, death, or December 2017, whichever came earliest. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD were calculated using Cox proportional hazards regression by PM exposure levels. Compared with cancer survivors in the lowest quintile of PM2.5 exposure, those within the highest quintile had a greater risk for CVD (aHR 1.31, 95% CI 1.07–1.59). Conversely, increasing PM10 and PM2.5–10 levels were not associated with increased CVD risk (p for trend 0.078 and 0.361, respectively). Cancer survivors who reduce PM2.5 exposure may benefit from lower risk of developing CVD.
Highlights
With the increasing incidence and the improved survival of patients with cancer, the number of cancer survivors is rapidly increasing in Korea
Participants residing in areas with the highest PM2.5 levels were younger, had higher household income, and had less comorbidities
PM10, cancer survivors residing in the highest levels of PM10 were younger, had higher household income, and had less comorbidities
Summary
With the increasing incidence and the improved survival of patients with cancer, the number of cancer survivors is rapidly increasing in Korea. In 2016, 229,180 Koreans were newly diagnosed with cancer, while 78,194 died from cancer. The recent 5-year relative survival rate for cancer patients in. Korea was 70.6%, which was similar to that reported in the US of 67.1% [1,2]. A million people in Korea have survived for more than 5 years after their cancer diagnosis, compared to over 11 million in the US [3,4]. Mortality from primary cancers accounts for up to 38.0% of all-cause mortality among cancer patients, while cardiovascular diseases (CVD) accounts for 11.3% [5].
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