High cardiovascular disease mortality after endometrial cancer diagnosis: Results from the Surveillance, Epidemiology, and End Results (SEER) Database

Felix, Ashley S.; Bower, Julie K.; Pfeiffer, Ruth M.; Raman, Subha V.; Cohn, David E.; Sherman, Mark E.

doi:10.1002/ijc.30470

Cited by 92 publications

(69 citation statements)

References 44 publications

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“…We found a significantly higher risk of CVM among patients with NHL than in the general US population and in patients with other cancers known to be associated with increased CVM risk. A SEER‐based study reported SMRs of 1.61 (95% CI: 1.21‐2.24) in patients with testicular seminoma, 2.4 (95% CI: 2.1‐2.7) in those with oral and oropharyngeal squamous carcinoma, and 8.8 (95% CI: 8.7‐9) in those with endometrial cancer . Furthermore, the higher risk was more pronounced among younger patients, as the SMR for CVM decreased with age.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular mortality among patients with non‐Hodgkin lymphoma: Differences according to lymphoma subtype

Abuamsha

Kadri

Hernandez

2019

Hematological Oncology

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Survival rates of patients with non‐Hodgkin lymphoma (NHL) have improved over the last decade. However, cardiotoxicities remain important adverse consequences of treatment with chemotherapy and radiation, although the burden of cardiovascular mortality (CVM) in such patients remains unknown. We conducted a retrospective cohort study of patients greater than or equal to 20 years of age diagnosed with diffuse large B‐cell lymphoma (DLBCL), follicular lymphoma (FL), and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) between 2000 and 2013 using data extracted from the United States Surveillance, Epidemiology, and End Results (SEER) database. Our primary endpoint was CVM. The association between NHL and CVM was evaluated using multivariable Cox regression analysis after adjusting for other patient characteristics. We calculated standardized mortality ratios (SMRs) for CVM, comparing NHL patients with the general population. We identified 153 983 patients who met the inclusion criteria (69 329 with DLBCL, 48 650 with CLL/SLL, and 36 004 with FL). The median follow‐up was 37 months (interquartile range, 10‐78 months); the mean patient age was 66.24 (±14.69) years; 84 924 (55.2%) were men; 134 720 (87.5%) were White, and 131 912 (85.7%) did not receive radiation therapy. Overall, 9017 patients (5.8%) died from cardiovascular disease, and we found that NHL patients had a higher risk of CVM than the general population, after adjusting for age (SMR 15.2, 95% confidence interval: 14.89‐15.52). The rates of CVM were 5.1%, 8%, and 4.4% in patients with DLBCL, CLL/SLL, and FL, respectively. Furthermore, across all NHL subtypes, older age, higher stage at the time of diagnosis (particularly stage 4), male sex, and living in the south were associated with higher risks of CVM. Our data suggest that risk assessment and careful cardiac monitoring are recommended for NHL patients, particularly those with the CLL/SLL subtypes.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular mortality among patients with non‐Hodgkin lymphoma: Differences according to lymphoma subtype

Abuamsha

Kadri

Hernandez

2019

Hematological Oncology

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“…The association between CVD risk after an EC diagnosis has been examined in a retrospective analysis of the Surveillance, Epidemiology, End Results (SEER) program [10] and in two cohort studies including EC cases and matched, cancer-free women [11, 12]. In our SEER analysis, we demonstrated an eight-fold higher risk of CVD mortality among 157,496 women with EC compared with women in the general population [10].…”

Section: Discussionmentioning

confidence: 83%

“…In our SEER analysis, we demonstrated an eight-fold higher risk of CVD mortality among 157,496 women with EC compared with women in the general population [10]. The major limitations of the SEER analysis included the use of an external comparison group that may have differed in key ways from the cancer cases and the inability to adjust for potential confounders.…”

Section: Discussionmentioning

confidence: 99%

“…Three studies have compared CVD mortality between women with and without EC, one reporting significantly higher CVD mortality among women with EC [10], one reporting significantly lower CVD mortality among women with EC [11], and one showing no difference [12]. To further examine CVD outcomes post-EC diagnosis, we used the large, prospective Women’s Health Initiative (WHI) study to examine the incidence of fatal and non-fatal CVD events among women who developed EC after study enrollment, compared with women who did not develop this cancer.…”

Section: Introductionmentioning

confidence: 99%

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Risk of cardiovascular disease among women with endometrial cancer compared to cancer-free women in the Women’s Health Initiative

Felix

Lehman

Foraker

et al. 2017

Cancer Epidemiology

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Background The majority of women diagnosed with endometrial cancer (EC) have low cancer-specific mortality; however, a high prevalence of cardiovascular disease (CVD) risk factors places EC patients at high risk of developing CVD. In the Women’s Health Initiative (WHI), we assessed the hypothesis that CVD risk was higher among women who developed EC compared with women who did not develop EC. Methods We compared the incidence of fatal and non-fatal CVD events among 1,179 women who developed Type I EC, 211 women who developed Type II EC, and 92,217 women who did not develop EC. We first estimated univariable cause-specific hazard ratios (CHRs) and 95% confidence intervals (CIs) for the association between an EC diagnosis (overall and by EC type) with CVD risk using Cox proportional hazards regression. Potential confounders were examined using a risk factor modeling approach; final multivariable-adjusted models included covariates that changed univariable CHRs for EC diagnosis by ≥ 5%. Results In multivariable-adjusted models, CVD risk did not significantly differ between women who developed EC compared to women who did not develop EC (CHR=1.01, 95% CI=0.87–1.16), particularly for the subgroup of women who developed Type I EC (CHR=0.98, 95% CI=0.84–1.14); however, there was a positive but statistically nonsignificant association for Type II EC (CHR=1.32, 95% CI=0.88–1.97). Conclusion Despite our null findings, women with EC should still receive counseling and support to make lifestyle changes aimed at reducing weight as appropriate, given the high prevalence of CVD risk factors at diagnosis.

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“…One potential solution to this would be to apply multivariate modeling procedures as in the Fine-Gray model (Fine & Gray, 1999) as used by Felix et. al (Felix et al, 2017). However, that approach is only applicable for a proportional hazards model.…”

Section: Discussionmentioning

confidence: 99%

Assessment of spatial variation in breast cancer-specific mortality using Louisiana SEER data

Carroll

Lawson

Jackson

et al. 2017

Social Science & Medicine

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Background Previous studies suggest spatial differences in mortality for many types of cancer, including breast cancer. Identifying explanations for these spatial differences results in a better understanding of what leads to longer survival time. Methods We used a Bayesian accelerated failure time model with spatial frailty terms to investigate potential spatial differences in breast cancer mortality following breast cancer diagnosis using 2000–2013 Louisiana SEER data. Results There are meaningful spatial differences in breast cancer mortality across the parishes of Louisiana, even after adjusting for known demographic and clinical risk factors. For example, the average survival time of a woman diagnosed in Orleans parish was 1.51 times longer than that of a woman diagnosed in Terrebonne parish. Additionally, there is evidence to suggest shorter survival times in lower income parishes along the Red and Mississippi Rivers, as well as parishes with lower socioeconomic status, less access to care and fresh food, worse quality of care, and more workers in certain industries. Conclusion The addition of spatial frailties to account for an individual's geographic location is useful when analyzing breast cancer mortality data. Our findings suggest that survival following breast cancer diagnosis could potentially be improved if socioeconomic status differences were addressed, healthcare improved in quality and became more accessible, and certain industrial situations were improved for individuals diagnosed in parishes identified as having shorter average survival times.

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High cardiovascular disease mortality after endometrial cancer diagnosis: Results from the Surveillance, Epidemiology, and End Results (SEER) Database

Cited by 92 publications

References 44 publications

Cardiovascular mortality among patients with non‐Hodgkin lymphoma: Differences according to lymphoma subtype

Cardiovascular mortality among patients with non‐Hodgkin lymphoma: Differences according to lymphoma subtype

Risk of cardiovascular disease among women with endometrial cancer compared to cancer-free women in the Women’s Health Initiative

Assessment of spatial variation in breast cancer-specific mortality using Louisiana SEER data

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