Sean Soisson1,2, Patricia A Ganz3, David Gaffney4,2, Kerry Rowe5, John Snyder1,5, Yuan Wan6, Vikrant Deshmukh7, Mike Newman7, Alison Fraser6, Ken Smith6, Kimberly Herget8, Heidi A Hanson9,6, Yelena P Wu10,2, Joseph Stanford, Ali Al-Sarray1,2, Theresa L Werner11,2, Veronica W Setiawan12, Mia Hashibe1,2. 1. Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT. 2. Huntsman Cancer Institute, Salt Lake City, UT. 3. Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA. 4. Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT. 5. Intermountain Healthcare, Salt Lake City, UT. 6. Pedigree and Population Resources, Population Sciences, Salt Lake City, UT. 7. University of Utah Health Sciences Center, Salt Lake City, UT. 8. Utah Cancer Registry, Salt Lake City, UT. 9. Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT. 10. Department of Dermatology, University of Utah School of Medicine, Salt Lake City, UT. 11. Division of Oncology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT. 12. Department of Preventive Medicine, Keck School of Medicine of USC, Los Angeles, CA.
Abstract
Background: Endometrial cancer is the second most common cancer among female cancer survivors in the United States. Cardiovascular disease is the leading cause of death among endometrial cancer survivors. Studies that examine long-term cardiovascular outcomes among endometrial cancer survivors are critical. Methods: Cohorts of 2648 endometrial cancer survivors diagnosed between 1997 and 2012 and 10 503 age-matched women from the general population were identified. Cardiovascular disease diagnoses were identified from electronic medical records and statewide ambulatory surgery and statewide inpatient data. Cox regression models were used to estimate hazard ratios (HRs) at one to five years, more than five to 10 years, and more than 10 years after cancer diagnosis. Results: Between one and five years after diagnosis, increased cardiovascular risks among endometrial cancer survivors were observed for phlebitis, thrombophlebitis, and thromboembolism (HR = 2.07, 99% confidence interval [CI] = 1.57 to 2.72), pulmonary heart disease (HR = 1.74, 99% CI = 1.26 to 2.40), and atrial fibrillation (HR = 1.50, 99% CI = 1.07 to 2.11). At more than five to 10 years, some elevated risk persisted for cardiovascular diseases. Compared with patients who had surgery, patients who additionally had radiation therapy and/or chemotherapy were at increased risk for heart and circulatory system disorders between one and five years after cancer diagnosis. Older age and obesity were also risk factors for hypertension and heart disease among endometrial cancer survivors. Conclusions: Endometrial cancer survivors are at higher risk for various adverse long-term cardiovascular outcomes compared with women from the general population. This study suggests that increased monitoring for cardiovascular diseases may be necessary for endometrial cancer patients for 10 years after cancer diagnosis.
Background: Endometrial cancer is the second most common cancer among female cancer survivors in the United States. Cardiovascular disease is the leading cause of death among endometrial cancer survivors. Studies that examine long-term cardiovascular outcomes among endometrial cancer survivors are critical. Methods: Cohorts of 2648 endometrial cancer survivors diagnosed between 1997 and 2012 and 10 503 age-matched women from the general population were identified. Cardiovascular disease diagnoses were identified from electronic medical records and statewide ambulatory surgery and statewide inpatient data. Cox regression models were used to estimate hazard ratios (HRs) at one to five years, more than five to 10 years, and more than 10 years after cancer diagnosis. Results: Between one and five years after diagnosis, increased cardiovascular risks among endometrial cancer survivors were observed for phlebitis, thrombophlebitis, and thromboembolism (HR = 2.07, 99% confidence interval [CI] = 1.57 to 2.72), pulmonary heart disease (HR = 1.74, 99% CI = 1.26 to 2.40), and atrial fibrillation (HR = 1.50, 99% CI = 1.07 to 2.11). At more than five to 10 years, some elevated risk persisted for cardiovascular diseases. Compared with patients who had surgery, patients who additionally had radiation therapy and/or chemotherapy were at increased risk for heart and circulatory system disorders between one and five years after cancer diagnosis. Older age and obesity were also risk factors for hypertension and heart disease among endometrial cancer survivors. Conclusions: Endometrial cancer survivors are at higher risk for various adverse long-term cardiovascular outcomes compared with women from the general population. This study suggests that increased monitoring for cardiovascular diseases may be necessary for endometrial cancerpatients for 10 years after cancer diagnosis.
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Authors: Morgan M Millar; Anita Y Kinney; Nicola J Camp; Lisa A Cannon-Albright; Mia Hashibe; David F Penson; Anne C Kirchhoff; Deborah W Neklason; Alicia W Gilsenan; Gretchen S Dieck; Antoinette M Stroup; Sandra L Edwards; Carrie Bateman; Marjorie E Carter; Carol Sweeney Journal: Am J Epidemiol Date: 2019-05-01 Impact factor: 4.897
Authors: Seungmin Kim; Jihye Park; Yuji Chen; Kerry Rowe; John Snyder; Alison Fraser; Ken Smith; Vikrant G Deshmukh; Michael Newman; Kimberley Herget; Christina A Porucznik; Dominik Ose; Mary Playdon; David Gaffney; Mia Hashibe Journal: Gynecol Oncol Date: 2019-12-12 Impact factor: 5.482