Highlights
- •Women with endometrial cancer had a higher prevalence of CVD at their cancer diagnosis than matched women without cancer.
- •Incidence of new CVD diagnoses was also higher among endometrial cancer survivors than women without cancer.
- •Monitoring for CVD may be critical during endometrial cancer treatment and throughout long-term survivorship.
Abstract
Background
Endometrial cancer (EC) shares risk factors (e.g. obesity) with cardiovascular disease
(CVD), yet little research has investigated CVD diagnoses among EC survivors. We aimed
to describe the burden of CVD diagnoses among older women with EC compared to women
without a cancer history.
Methods
Women aged 66+ years with an EC diagnosis during 2004–2017 (N = 44,386) and matched women without cancer (N = 221,219) were identified in the SEER-Medicare linked data. An index date was defined
as the cancer diagnosis date of the EC case in that matched set. ICD-9/10 diagnosis
codes were used to define CVD outcomes in the Medicare claims. Prevalent CVD was identified
using diagnosis codes in the year before the index date. Hazard ratios (HRs) for incident
CVD diagnoses after the index date were estimated using multivariable Cox proportional
hazards regression. Women with a prevalent CVD were excluded from incidence analyses
for that outcome.
Results
Compared to women without cancer, women with EC had a higher prevalence of CVD diagnoses
at the index date. In analyses beginning follow-up at 1 year post-index date, EC survivors
had an increased risk of incident CVD diagnoses including ischemic heart diseases
(HR = 1.73; 95% CI: 1.69–1.78), pulmonary heart disease (HR = 1.95; 95% CI: 1.88–2.02),
and diseases of the veins and lymphatics (HR = 2.71; 95% CI: 95% CI: 2.64–2.78). Risk
of CVD diagnoses among women with EC was also elevated within the first year post-index
date.
Conclusions
Management of pre-existing CVD and monitoring for incident CVD may be critical during
EC treatment and throughout long-term survivorship.
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Article info
Publication history
Published online: August 22, 2022
Accepted:
August 16,
2022
Received in revised form:
August 10,
2022
Received:
June 21,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
