Women with endometrial cancer at higher risk for cardiovascular diseases: Study

USA: When compared to women without a history of cancer but with similar demographics, women with endometrial cancer had a higher prevalence of cardiovascular disease (CVD)-related disorders at the time of their cancer diagnosis, states a study published in the journal Gynecologic Oncology.

With an anticipated 65,950 new cases in 2022, endometrial cancer is ranked as the fourth most often diagnosed cancer among American women. Few studies have looked at CVD diagnoses among endometrial cancer survivors, despite the fact that EC and CVD share risk factors, such as obesity. To fill this knowledge gap, authors aimed to compare older women with EC to women without a history of cancer to assess the prevalence of CVD diagnoses among older women with EC.

For this research, the SEER-Medicare linked data were used to identify women aged 66+ with an EC diagnosis between 2004 and 2017 (N = 44,386) and similar women without cancer (N = 221,219). The date that the EC case in that matched set received a cancer diagnosis served as an index date. When defining CVD outcomes in Medicare claims, ICD-9/10 diagnostic codes were employed. In the year prior to the index date, prevalent CVD was determined using diagnosis codes. A multivariable Cox proportional hazards regression was used to estimate the hazard ratios (HRs) for incident CVD diagnoses made after the index date. Incidence analyses for that outcome were not conducted on women who had a prevalent CVD.

Key findings of the research:

• Women with EC had a greater prevalence of CVD diagnoses at the index date when compared to women without cancer.
• EC survivors had a higher risk of incident CVD diagnoses, such as ischemic heart diseases (HR = 1.73; 95% CI: 1.69-1.78), pulmonary heart diseases (HR = 1.95; 95% CI: 1.88-2.02), and diseases of the veins and lymphatics (HR = 2.71; 95% CI: 2.64-2.78).
• Within the first year following the index date, women with EC had a higher risk of receiving a CVD diagnosis.
• The proportions of fatalities from endometrial cancer (26%) and cardiovascular diseases (26%), which affect patients with localized stage cancer, were comparable.
• Compared to women with localized stage disease, women with regional or remote stage disease were more likely to be diagnosed with CVD.
• Black women had a higher likelihood of being diagnosed with CVD than White women.

"For older women newly diagnosed with endometrial cancer, a careful assessment of CVD history and management of prevalent CVD-related conditions may be a particularly crucial component of oncology care. This is because these pre-existing situations may influence cancer treatment options and require additional medical assistance from non-cancer specialists", the researchers wrote.

The authors concluded that managing pre-existing CVD and keeping an eye out for incident CVD may be crucial throughout EC treatment and long-term survivability.

REFERENCE

Anderson C, Olshan AF, Bae-Jump VL, Brewster WR, Lund JL, Nichols HB. Cardiovascular disease diagnoses among older women with endometrial cancer. Gynecol Oncol. 2022 Aug 22:S0090-8258(22)00553-4. doi: 10.1016/j.ygyno.2022.08.014. Epub ahead of print. PMID: 36008183.