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Cardiovascular mort...
Cardiovascular mortality among cancer survivors who developed breast cancer as a second primary malignancy
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- Wang, Chengshi (författare)
- Laboratory of Molecular Diagnosis of Cancer, Clinical Research Center for Breast Diseases, West China Hospital, Sichuan University, Chengdu, China
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- Hu, Kejia (författare)
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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- Luo, Chuanxu (författare)
- Laboratory of Molecular Diagnosis of Cancer, Clinical Research Center for Breast Diseases, West China Hospital, Sichuan University, Chengdu, China
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- Deng, Lei (författare)
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx NY, USA
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- Fall, Katja, 1971- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Clinical Epidemiology and Biostatistics
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- Tamimi, Rulla M. (författare)
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston MA, USA
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- Fang, Fang (författare)
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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- Valdimarsdóttir, Unnur A. (författare)
- Harvard T.H. Chan School of Public Health, Boston MA, USA
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- Lu, Donghao (författare)
- Karolinska Institutet, Solna, Sweden
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(creator_code:org_t)
- American Association for Cancer Research, 2020
- 2020
- Engelska.
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Ingår i: Cancer Research. - : American Association for Cancer Research. - 0008-5472 .- 1538-7445. ; 80:16
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
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- Background: Patients with breast cancer are at increased risk of cardiovascular diseases and cardiovascular mortality, potentially due to treatment-related cardiotoxicity, early menopause, and psychological distress. Cancer survivors who developed breast cancer as a second malignancy (BCa-2) are common and may experience cancer treatment and distress for a second time. It is however unknown whether BCa-2 patients have increased risk of cardiovascular mortality compared to patients with breast cancer as the first malignancy (BCa-1) and the cancer-free female population.Methods: Using the Surveillance, Epidemiology, and End Results database, we conducted a cohort study including 1,024,047 patients with BCa-1 and 41,744 with BCa-2 diagnosed at age of 30 years and older during 1975-2016, and the corresponding female population of 994,415,911 person-years in the U.S.. Compared with patients with BCa-1 and the general population, we calculated incidence rate ratios (IRRs) of cardiovascular deaths among patients with BCa-2 by using multivariable Poisson regression.Results: During the median follow-up of 5.9 years (interquartile range, 2.4-11.3 years), 3,550 and 71,298 cardiovascular deaths were observed in BCa-2 and BCa-1 patients. Overall, BCa-2 patients had a mildly increased risk of cardiovascular mortality compared with the general population (IRR 1.07, 95% CI 1.03-1.10) and BCa-1 patients (IRR 1.13, 95% CI 1.10-1.17) with the adjustment of demographic factors. When comparing BCa-2 with BCa-1, the association was further independent of tumor characteristics and treatment modes (IRR 1.15, 95% CI 1.11-1.19). The elevated risk of cardiovascular mortality was mostly pronounced at age of follow-up between 30 and 79 years (IRR 1.31, 95% CI 1.23-1.40 compared with the general population; IRR 1.34, 95% CI 1.25-1.43 compared with BCa-1), whereas the risk was mildly increased, if any, at age of 80+ years compared with BCa-1 (IRR 1.07, 95% CI 1.02-1.11). The increased risk at age of 30-79 years in BCa-2 was particularly greater within the first month after cancer diagnosis compared with the general population (IRR 3.20, 95% CI 2.34-4.38). In contrast, cardiovascular mortality rate in BCa-2 was comparable to that in BCa-1 within the first month (IRR 0.87, 95% CI 0.63-1.21).Conclusions: Our findings suggest that patients with BCa-2, particularly in patients younger than 80 years, are at increased risk of cardiovascular mortality, compared with the general population and patients with BCa-1.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
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- Av författaren/redakt...
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Wang, Chengshi
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Hu, Kejia
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Luo, Chuanxu
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Deng, Lei
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Fall, Katja, 197 ...
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Tamimi, Rulla M.
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Fang, Fang
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Valdimarsdóttir, ...
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Lu, Donghao
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Cancer och onkol ...
- Artiklar i publikationen
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Cancer Research
- Av lärosätet
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Örebro universitet
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Karolinska Institutet