Advertisement

The intersection of gynecologic cancer, obesity, and cardiovascular disease

      Over the last decade, the link between cancer and cardiovascular disease has been the subject of a growing number of epidemiological studies [
      • Strongman H.
      • Gadd S.
      • Matthews A.
      • Mansfield K.E.
      • Stanway S.
      • Lyon A.R.
      • Dos-Santos-Silva I.
      • Smeeth L.
      • Bhaskaran K.
      Medium and long-term risks of specific cardiovascular diseases in survivors of 20 adult cancers: a population-based cohort study using multiple linked UK electronic health records databases.
      ,
      • Navi B.B.
      • Reiner A.S.
      • Kamel H.
      • Iadecola C.
      • Okin P.M.
      • Elkind M.S.V.
      • Panageas K.S.
      • DeAngelis L.M.
      Risk of arterial thromboembolism in patients with cancer.
      ,
      • Armenian S.H.
      • Xu L.
      • Ky B.
      • Sun C.
      • Farol L.T.
      • Pal S.K.
      • Douglas P.S.
      • Bhatia S.
      • Chao C.
      Cardiovascular disease among survivors of adult-onset cancer: a community-based retrospective cohort study.
      ,
      • Paterson D.I.
      • Wiebe N.
      • Cheung W.Y.
      • Mackey J.R.
      • Pituskin E.
      • Reiman A.
      • Tonelli M.
      Incident cardiovascular disease among adults with cancer.
      ], 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. [
      • Strongman H.
      • Gadd S.
      • Matthews A.
      • Mansfield K.E.
      • Stanway S.
      • Lyon A.R.
      • Dos-Santos-Silva I.
      • Smeeth L.
      • Bhaskaran K.
      Medium and long-term risks of specific cardiovascular diseases in survivors of 20 adult cancers: a population-based cohort study using multiple linked UK electronic health records databases.
      ] 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. Several factors likely contribute to the increased burden of cardiovascular disease among cancer survivors: first, advances in cancer treatments have led to decreasing cancer-specific mortality for individuals diagnosed with certain cancers, including breast and colorectal cancers, leading to a growing population of cancer survivors who are unlikely to die from their malignancy [
      • Siegel R.L.
      • Miller K.D.
      • Fuchs H.E.
      • Jemal A.
      Cancer statistics, 2022.
      ]. At the same time, the cardiotoxic profile associated with certain chemotherapy and immunotherapy agents, along with radiotherapy, have increased the risk of developing cardiovascular diseases following a cancer diagnosis [
      • Moslehi J.J.
      Cardiovascular toxic effects of targeted cancer therapies.
      ]. In addition, shared etiologies of cancer and cardiovascular disease, which reflect common biological pathways, certainly contributes to the intersection of these chronic diseases [
      • Koene R.J.
      • Prizment A.E.
      • Blaes A.
      • Konety S.H.
      Shared Risk Factors in Cardiovascular Disease and Cancer.
      ]. It is important to note the existence of heterogeneous associations between different cancer sites and different cardiovascular disease events, which makes the work of Coughlin and colleagues [
      • Coughlin S.S.
      • Datta B.
      • Guha A.
      • Wang X.
      • Weintraub N.L.
      Cardiovascular conditions and obesity among gynecologic cancer survivors: results from the 2020 behavioral risk factor surveillance system survey.
      ] in this issue of Gynecologic Oncology an important addition to the literature.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Gynecologic Oncology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Strongman H.
        • Gadd S.
        • Matthews A.
        • Mansfield K.E.
        • Stanway S.
        • Lyon A.R.
        • Dos-Santos-Silva I.
        • Smeeth L.
        • Bhaskaran K.
        Medium and long-term risks of specific cardiovascular diseases in survivors of 20 adult cancers: a population-based cohort study using multiple linked UK electronic health records databases.
        Lancet. 2019; 394: 1041-1054
        • Navi B.B.
        • Reiner A.S.
        • Kamel H.
        • Iadecola C.
        • Okin P.M.
        • Elkind M.S.V.
        • Panageas K.S.
        • DeAngelis L.M.
        Risk of arterial thromboembolism in patients with cancer.
        J. Am. Coll. Cardiol. 2017; 70: 926-938
        • Armenian S.H.
        • Xu L.
        • Ky B.
        • Sun C.
        • Farol L.T.
        • Pal S.K.
        • Douglas P.S.
        • Bhatia S.
        • Chao C.
        Cardiovascular disease among survivors of adult-onset cancer: a community-based retrospective cohort study.
        J. Clin. Oncol. 2016; 34: 1122-1130
        • Paterson D.I.
        • Wiebe N.
        • Cheung W.Y.
        • Mackey J.R.
        • Pituskin E.
        • Reiman A.
        • Tonelli M.
        Incident cardiovascular disease among adults with cancer.
        JACC: CardioOncology. 2022; 4: 85-94
        • Siegel R.L.
        • Miller K.D.
        • Fuchs H.E.
        • Jemal A.
        Cancer statistics, 2022.
        CA Cancer J. Clin. 2022; 72: 7-33
        • Moslehi J.J.
        Cardiovascular toxic effects of targeted cancer therapies.
        N. Engl. J. Med. 2016; 375: 1457-1467
        • Koene R.J.
        • Prizment A.E.
        • Blaes A.
        • Konety S.H.
        Shared Risk Factors in Cardiovascular Disease and Cancer.
        Circulation. 2016; 133: 1104-1114
        • Coughlin S.S.
        • Datta B.
        • Guha A.
        • Wang X.
        • Weintraub N.L.
        Cardiovascular conditions and obesity among gynecologic cancer survivors: results from the 2020 behavioral risk factor surveillance system survey.
        Gynecol. Oncol. 2022; 165: 405-409
        • Bradshaw P.T.
        • Stevens J.
        • Khankari N.
        • Teitelbaum S.L.
        • Neugut A.I.
        • Gammon M.D.
        Cardiovascular disease mortality among breast cancer survivors.
        Epidemiology. 2016; 27: 6-13
        • Appiah D.
        • Farias R.M.
        • Olokede O.A.
        • Nwabuo C.C.
        • Bhende K.M.
        • Ebong I.A.
        • Byrd T.L.
        • Nair N.
        The influence of individual and neighborhood-level characteristics on rural-urban disparities in cardiovascular disease mortality among U.S. women diagnosed with breast and gynecologic cancers.
        Gynecol. Oncol. 2021; 161: 483-490
        • Drobni Z.D.
        • Alvi R.M.
        • Taron J.
        • Zafar A.
        • Murphy S.P.
        • Rambarat P.K.
        • Mosarla R.C.
        • Lee C.
        • Zlotoff D.A.
        • Raghu V.K.
        • Hartmann S.E.
        • Gilman H.K.
        • Gong J.
        • Zubiri L.
        • Sullivan R.J.
        • Reynolds K.L.
        • Mayrhofer T.
        • Zhang L.
        • Hoffmann U.
        • Neilan T.G.
        Association between immune checkpoint inhibitors with cardiovascular events and atherosclerotic plaque.
        Circulation. 2020; 142: 2299-2311
        • DeStephano C.C.
        • Bakkum-Gamez J.N.
        • Kaunitz A.M.
        • Ridgeway J.L.
        • Sherman M.E.
        Intercepting endometrial cancer: opportunities to expand access using new technology.
        Cancer Prev. Res. (Phila.). 2020; 13: 563-568

      Linked Article