Breast cancer survivors at increased risk of diabetes and hypertension: ASCO

USA: In a new study conducted by Marilyn L. Kwan and team, it was found that breast cancer (BC) survivors at Kaiser Permanente Northern California (KPNC) had higher risks of diabetes and hypertension than non-BC women, depending on therapy and body mass index (BMI). The findings of this study were published in the Journal of Clinical Oncology.

The prevalence of cardiometabolic risk factors in breast cancer (BC) survivors is poorly understood. As a result, the researchers compared the risk of diabetes, dyslipidemia, and hypertension in women with and without BC.

Women with invasive breast cancer diagnosed at Kaiser Permanente Northern California (KPNC) between 2005 and 2013 were identified and matched 1:5 to noncancer controls based on birth year, race, and ethnicity. With the competing risk of total death, the cumulative incidence rates of hypertension, diabetes, and dyslipidemia were calculated. Fine and Gray regression was used to calculate subdistribution hazard ratios (sHRs), which were adjusted for cardiovascular disease-related risk variables and stratified by therapy and BMI.

The key findings of this study were as follow:

1. A total of 14,942 BC cases and 74,702 matched controls were found, with a mean age of 61.2 years and a non-Hispanic White population of 65%.

2. After two years, BC patients exhibited higher cumulative incidence rates of hypertension and diabetes than controls, with the increased diabetes incidence remaining after ten years.

3. Cases showed a greater risk of diabetes than controls in multivariable models.

4. Diabetes risk remained increased in those treated with chemotherapy, left-sided radiotherapy, or endocrine treatment.

5. The risk of hypertension was increased in patients who had left-sided radiotherapy or hormone treatment.

6. Cases of normal weight (BMI 24.9 kg/m2) exhibited greater risks overall and within treatment subgroups compared to controls.

In conclusion, the findings of the study emphasize patients with BC as a vulnerable population at increased risk of cardiometabolic risk factors, and they advocate tailored cardiovascular surveillance based on unique patient and therapy features to reduce these risks.

Reference:

Kwan ML, Cheng RK, Iribarren C, Neugebauer R, Rana JS, Nguyen-Huynh M, Shi Z, Laurent CA, Lee VS, Roh JM, Shen H, Rillamas-Sun E, Santiago-Torres M, Hershman DL, Kushi LH, Greenlee H. Risk of Cardiometabolic Risk Factors in Women With and Without a History of Breast Cancer: The Pathways Heart Study. J Clin Oncol. 2022 Jan 13:JCO2101738. doi:10.1200/JCO.21.01738.