Estimating burden of cardiovascular disease among survivors of breast, colorectal, lung, and prostate cancer in the detroit research on cancer survivors (ROCS) cohort.

Abstract

12082 Background: With new advances in cancer treatment, cancer-specific mortality has decreased by 31% over the past 3 decades. The growing number of cancer survivors has led to increased risk of other chronic conditions including cardiovascular disease (CVD), which has become an important competing cause of mortality. This study evaluates the incidence of CVD, including heart failure (HF), myocardial infarction (MI), coronary artery disease (CAD), atrial fibrillation (AF) and stroke after cancer in the Detroit ROCS cohort. Methods: ROCS is an African American cancer survivorship cohort that enrolled participants residing in the tri-county Detroit Metropolitan area. This study included survivors of breast, colorectal, lung, and prostate cancer who provided socio-demographic and clinic information on self-administered questionnaires. We calculated incidence as percentages and rates per 1,000 person-years of HF, MI, CAD, AF, and stroke after cancer. Multivariate logistic regression analysis was used to evaluate the relationship between socio-demographic and clinical predictors of CVD by using factors with p-value < 0.1. Results: After excluding patients with pre-existing CVD or lack of data on comorbidities, the study cohort consisted of 2,865 participants. The mean (SD) age at cancer diagnosis was 60.3 (9.4) years with median follow up of 3.0 (1.0-9.3) years. The incidence rate for any CVD was 23.3 per 1,000 person-years. In the study sample, stroke was the leading CVD, followed by HF, AF, CAD and MI. Lung cancer survivors had the highest incidence of CVD followed by prostate, breast, and colorectal cancer. Age at cancer diagnosis, household income, insurance, aspirin, smoking, body mass index, hypertension, diabetes, and high cholesterol were included in the final model. In the multivariate analysis, decreased household income [OR 1.26 (95% CI 1.05-1.52)], prior aspirin use [OR 1.83 (95% CI 1.34-2.49)], and history of hypertension [OR 1.71 (95% CI 1.20-2.44)] were associated with higher odds of CVD. Conclusions: CVD is a relatively common outcome within years after cancer diagnosis in an African American survivorship cohort. Intervention should focus on the possible impact of socioeconomic variables and control of hypertension in reducing the risk of CVD after cancer. [Table: see text]