Cancer Screening in Patients with Heart Failure with Mildly Reduced and Reduced Ejection Fraction

Abstract

Background: Heart failure with mildly reduced and reduced ejection fraction are associated with incident cancer. However, cancer screening is not routinely discussed in this population. This study aimed to describe the uptake and perception of cancer screening among patients with heart failure attending a specialised heart failure clinic in Australia. Methods: A prospective survey of consecutive ambulatory patients attending the clinic from 2022–2023 was performed. Included patients were eligible for recommended breast, cervical and/or bowel cancer screening according to Australian guidelines, had an ejection fraction of <50% and no prior history of cancer. The primary endpoint was adherence to recommended cancer screening according to Australian guidelines. Perceptions towards cancer screening were also assessed and cancer screening rates were compared with those of the general Australian population. Results: Among the 200 included patients, there was low uptake of recommended breast, bowel and cervical cancer screening despite the availability of free national cancer screening programmes. Cancer screening rates among heart failure patients were lower than observed in the general Australian population. Patients were unaware of the association between cancer and heart failure and expressed interest in cancer screening participation. Conclusion: Future efforts should be targeted at improving education on cancer screening among patients and cardiovascular healthcare providers to improve overall health outcomes in heart failure.