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Cardiovascular conditions and obesity among gynecologic cancer survivors: Results from the 2020 behavioral risk factor surveillance system survey

  • Steven S. Coughlin
    Correspondence
    Corresponding author at: Department of Population Health Sciences, Augusta University, 1120 15th Street, AE-1042, Augusta, GA 30912, United States of America.
    Affiliations
    Department of Population Health Sciences, Augusta University, Augusta, GA 30912, United States of America

    Institute of Public and Preventive Health, Augusta University, Augusta, GA, United States of America
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  • Biplab Datta
    Affiliations
    Department of Population Health Sciences, Augusta University, Augusta, GA 30912, United States of America

    Institute of Public and Preventive Health, Augusta University, Augusta, GA, United States of America
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  • Avirup Guha
    Affiliations
    Division of Cardiology, Department of Medicine, and Vascular Biology Center, Medical College of Georgia, Augusta University, Augusta, GA, United States of America
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  • Xiaoling Wang
    Affiliations
    Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA, United States of America
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  • Neal L. Weintraub
    Affiliations
    Division of Cardiology, Department of Medicine, and Vascular Biology Center, Medical College of Georgia, Augusta University, Augusta, GA, United States of America
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      Highlights

      • The prevalence of heart attack, CHD, and stroke were significantly higher (p < 0.001) among survivors of gynecologic cancer.
      • The prevalence of obesity was significantly higher among gynecologic cancer survivors (p < 0.001).
      • Gynecologic cancer survivors were more likely to be obese.

      Abstract

      Background

      With the increasing prevalence of gynecologic cancer and obesity, there is a growing population living with cardiovascular disease, obesity and gynecologic cancer concurrently or at risk of developing these disease states.

      Methods

      We examined cardiovascular (CV) conditions and obesity among 1824 gynecologic cancer survivors in a cross-sectional analysis, using data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS). Univariate and multivariable logistic regression methods were used in the analysis.

      Results

      The prevalence of heart attack, CHD, and stroke were significantly higher (p < 0.001) among survivors of gynecologic and other cancer survivors compared to women with no history of cancer. However, no statistically significant differences were observed across gynecologic and other cancer survivors. The prevalence of obesity among gynecologic cancer survivors was significantly higher (p < 0.001) than that in the other two groups. While around one-third of the women with no history of cancer and survivors of other types of cancer were obese, obesity prevalence was nearly 13%-points higher among survivors of gynecologic cancer. In multivariate analysis, gynecologic cancer survivors were 2.7 times more likely to have a heart attack compared to those without any history of cancer. The odds of CHD and stroke among survivors of gynecologic cancer were respectively 3.4 and 2.7 times that of those with no history of cancer. The adjusted odds were also similar, though smaller in magnitude. Gynecologic cancer survivors were also more likely to be obese −1.8 times that of those with no cancer.

      Conclusions

      Gynecologic cancer survivors are more likely than persons without a cancer history to have cardiovascular disease and other chronic illnesses, and they have a higher prevalence of heart attack, stroke, and obesity. These results underscore the sizeable opportunities for primary, secondary, and tertiary prevention of cardiovascular health conditions among gynecologic cancer survivors.

      Keywords

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      Linked Article

      • The intersection of gynecologic cancer, obesity, and cardiovascular disease
        Gynecologic OncologyVol. 165Issue 3
        • Preview
          Over the last decade, the link between cancer and cardiovascular disease has been the subject of a growing number of epidemiological studies [1–4], with findings from cross-sectional and longitudinal study designs generally reporting a higher cardiovascular disease burden among those with cancer compared to those without a cancer diagnosis. In one of the largest studies to examine this relationship among adult cancer survivors, Strongman et al. [1] reported increased medium-term to long-term risk for one or more specific cardiovascular diseases among survivors of several site-specific cancers compared to cancer-free controls in the general population, with substantial variations between cancer sites.
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