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Showing content from https://pubmed.ncbi.nlm.nih.gov/23417882/ below:

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

doi: 10.1007/s11764-013-0267-9. Epub 2013 Feb 16. Cardiovascular risk factors among long-term survivors of breast, prostate, colorectal, and gynecologic cancers: a gap in survivorship care?

Affiliations

Affiliation

¹ Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. keweaver@wakehealth.edu

PMID: 23417882
PMCID: PMC3756807
DOI: 10.1007/s11764-013-0267-9

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

Kathryn E Weaver et al. J Cancer Surviv. 2013 Jun.

doi: 10.1007/s11764-013-0267-9. Epub 2013 Feb 16. Affiliation

¹ Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. keweaver@wakehealth.edu

PMID: 23417882
PMCID: PMC3756807
DOI: 10.1007/s11764-013-0267-9

Item in Clipboard

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 = 1,582) 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 = 0.37, p = 0.007) and African-American (b = 0.66, p < 0.0001), 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.

Implications for cancer survivors: Cardiovascular disease may compromise cancer survivors' long-term health and well-being, yet cardiovascular risk factors may be overlooked during survivorship care. We document that CVD risk factors are common among cancers survivors, yet nearly a third of survivors do not report health promotion discussions with their medical teams. Survivors should be aware of their cardiovascular risk factors and initiate discussions with their medical teams about health promotion topics, if appropriate.

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Conflict of interest statement

Conflict of Interest: None

Figures
Figure 1

Weighted prevalence (%) of cardiovascular…

Figure 1

Weighted prevalence (%) of cardiovascular risk factors in long-term cancer survivors (FOCUS) and…

Figure 1

Weighted prevalence (%) of cardiovascular risk factors in long-term cancer survivors (FOCUS) and a comparison sample (CHIS) Weighted prevalence (%) and 95% confidence interval are shown and reported in Online Resource 1. The FOCUS sample was comprised of 4–14 year cancer survivors of breast, prostate, colorectal, and gynecologic cancers recruited from SEER cancer registries in California. The California Health Interview Survey (CHIS) sample was comprised of adults aged 50 to 93 residing in the same California counties that were covered by the SEER cancer registries. With the exception of a history of former smoking, all paired comparisons are significantly different, p <.05.

Figure 2

Figure 2a. Weighted prevalence of…

Figure 2

Figure 2a. Weighted prevalence of cardiovascular risk factors among long-term survivors (FOCUS) by…

Figure 2

Figure 2a. Weighted prevalence of cardiovascular risk factors among long-term survivors (FOCUS) by cancer site Weighted prevalence and 95% confidence interval are shown and reported in Online Resource 1. Physical activity was classified as meeting American College of Sports Medicine/ American Heart Association’s physical activity guidelines for adults[18] (150 minutes of moderate-intensity or 60 minutes of vigorous-intensity physical activity per week), some moderate or vigorous physical activity, but below guideline level, or those reporting no moderate and no vigorous activity in the past 4 weeks. Self-report of ever diagnosis with hypertension or diabetes defined these risk factors. 2a-There were significant overall differences by cancer site for all of the cardiovascular risk factors except diabetes and high cholesterol (p<.05). Odds ratios for comparison of each site to breast cancer are reported in the text. Figure 2b. Prevalence of cardiovascular risk factors among long-term cancer survivors (FOCUS) by race/ethnicity. 2b- There were significant overall differences by race/ethnicity for all of the cardiovascular risk factors except smoking (p<.05). Odds ratios for comparison of African American, Latino, and Asian survivors to white, non-Hispanic survivors are reported in the text.

Figure 2

Figure 2a. Weighted prevalence of…

Figure 2

Figure 2a. Weighted prevalence of cardiovascular risk factors among long-term survivors (FOCUS) by…

Figure 2