Open AccessTen-year cardiovascular risk among cancer survivors: The National Health and Nutrition Examination Survey
Author(s) -
Xiaochen Zhang,
Meghan Pawlikowski,
Susan OlivoMarston,
Karen Patricia Williams,
Julie K. Bower,
Ashley S. Felix
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0247919
Subject(s) - medicine , national health and nutrition examination survey , odds ratio , cancer , family history , cohort , population , prostate cancer , medical history , colorectal cancer , odds , logistic regression , environmental health
Background Cancer survivors have a higher risk of developing and dying from cardiovascular disease (CVD) compared to the general population. We sought to determine whether 10-year risk of atherosclerotic CVD (ASCVD) is elevated among those with vs. without a cancer history in a nationally representative U.S. sample. Methods Participants aged 40–79 years with no CVD history were included from the 2007–2016 National Health and Nutrition Examination Survey. Cancer history was self-reported and 10-year risk of ASCVD was estimated using Pooled Cohort Equations. We used logistic regression to estimate associations between cancer history and odds of elevated (≥7.5%) vs. low (<7.5%) 10-year ASCVD risk. An interaction between age and cancer history was examined. Results A total of 15,095 participants were included (mean age = 55.2 years) with 12.3% (n = 1,604) reporting a cancer history. Individuals with vs. without a cancer history had increased odds of elevated 10-year ASCVD risk (OR = 3.42, 95% CI: 2.51–4.66). Specifically, those with bladder/kidney, prostate, colorectal, lung, melanoma, or testicular cancer had a 2.72–10.47 higher odds of elevated 10-year ASCVD risk. Additionally, age was an effect modifier: a cancer history was associated with 1.24 (95% CI: 1.19–4.21) times higher odds of elevated 10-year ASCVD risk among those aged 60–69, but not with other age groups. Conclusions Adults with a history of self-reported cancer had higher 10-year ASCVD risk. ASCVD risk assessment and clinical surveillance of cardiovascular health following a cancer diagnosis could potentially reduce disease burden and prolong survival, especially for patients with specific cancers and high ASCVD risk.