Cardiovascular risk factors among long-term survivors of breast, prostate, colorectal, and gynecologic cancers: a gap in survivorship care?

Abstract

Purpose Individuals diagnosed with high survival cancers will often die of cardiovascular disease (CVD) rather than a recurrence of their cancer, yet CVD risk factors may be overlooked during survivorship care. We assess the prevalence of CVD risk factors among long-term cancer survivors and compare results to survey data from the general population in the same geographic region. We also characterize how often at-risk survivors discuss CVD-related health behaviors with their health care providers. Methods Survivors (n=1582) of breast, prostate, colorectal, and gynecologic cancers, 4–14 years after diagnosis, were recruited from two California cancer registries for a cross-sectional mail survey. We assessed CVD risk factors, including smoking, body mass index, physical inactivity, hypercholesterolemia, hypertension, and diabetes, as well as report of discussions with health care providers about diet, exercise, smoking, and lifestyle change assistance. Results With the exception of current smoking, CVD risk factors were more common among survivors than the general adult population. Of survivors, 62.0% were overweight or obese; 55.0% reported hypertension; 20.7% reported diabetes; 18.1% were inactive; and 5.1% were current smokers. Compared to white, non-Hispanic survivors, Hispanic (b= .37, p= .007) and African-American (b= .66, p<.0001), but not Asian survivors reported significantly more risk factors. One in three survivors with one or more risk factors for CVD did not report a health promotion discussion with their health care providers. Conclusions CVD risk factors are common among long-term survivors, but many at-risk survivors may not discuss lifestyle prevention with their health care team. Primary care and oncology should work together to deliver optimal survivorship care that addresses CVD risk factors, as well as prevalent disease.

Prevalence, Awareness, Control, and Treatment of Hypertension and Diabetes in Korean Cancer Survivors: A Cross-Sectional Analysis of the Fourth and Fifth Korea National Health and Nutrition Examination Surveys

“…Previous studies found no significant difference in the prevalence of hypertension between cancer survivors and non-cancer survivors (Enright et al, 2010),slightly higher prevalence in cancer survivors according to cancer types (Shin et al, 2008;Weaver et al, 2013), or specific treatment methods (Jain et al, 2007;Valentova et al, 2011). Hypertension was the most frequent comorbid condition treated in cancer survivors (Goytia et al, 2009), and there is a widespread need for the management of chronic diseases and related risk factors to reduce the late adverse effects of chemotherapy and radiation (Daher et al, 2012).…”

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“…3,[32][33][34][35][36][37][38][39][40] Four studies used self-reported history of cardiovascular diseases or cardiovascular disease risk factors as an operational definition. 23,28,30,31 Attributes According to Rodgers, attributes provide a "real definition as opposed to a nominal or dictionary definition". 12 Attributes are the features that comprise the concept as opposed to the conceptual definition of the concept.…”

Counties eliminating racial disparities in colorectal cancer mortality

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