You May Have Survived Cancer But Cardiovascular Risk
May Now Be Higher Than You Think
Cancer shares many of cardiovascular risk factors
such as smoking, low physical activity and obesity; cancer treatment
many not help heart either
April 16, 2013 – A study of survivors of breast,
prostate, colorectal and gynecologic cancers finds many of these people
end up dying of cardiovascular disease.
This new research finds that CVD risk factors may
be overlooked during survivorship care, according to the study by
Kathryn E. Weaver, Ph.D., assistant professor of social sciences and
health policy, and her colleagues at Wake Forest Baptist Center.
"Increasingly, we are concerned about
cardiovascular health in long-term cancer survivors, and we believe this
is a high-risk group that needs close attention," lead author Weaver
"As part of good survivorship health, it's going to
be increasingly important for health care providers to assess and
address cardiovascular risk in cancer survivors."
For example, Weaver said there is data showing that
early stage breast cancer patients are more likely to die of CVD than of
There are many reasons why cancer survivors have
higher CVD risks, she said, most typically because cancer shares many of
the same risk factors such as smoking, low physical activity and
obesity. Also, some of the treatments cancer patients undergo may put
them at higher risk, she said.
The survey participants were recruited from two
cancer registries. A total of 1,582 survivors who were four to 14 years
beyond diagnosis were asked in a mail survey to assess CVD risk factors,
including smoking, body mass index, physical inactivity, hypertension
The researchers also asked the participants whether
they had engaged in discussions with health care providers about making
lifestyle changes through diet, exercise and quitting smoking.
With the exception of current smoking, CVD risk
factors were more common among survivors than the general adult
population. Of survivors,
…62 percent were overweight or obese,
…55 percent reported hypertension,
…20.7 percent reported diabetes,
…18.1 percent were inactive, and
…5.1 percent were current smokers.
Nearly a third of survivors with CVD risk factors
did not report health-promotion discussions with their medical teams.
Weaver said they also saw significant differences
for Hispanic and African-American survivors when compared to white
survivors that are similar to those observed in adults without cancer.
These two ethnic groups had a greater number of CVD risk factors,
particularly obesity and diabetes.
"What we found is that cancer survivors do have
more cardiovascular risk factors than the general adult population, and
they often do not report talking with their health care provider about
ways to reduce their risk through lifestyle changes like exercising and
losing weight," Weaver said.
This study highlights the need for more awareness
by cancer survivors and their doctors, Weaver said. "Our message is that
cardiovascular disease risk should be assessed as part of a
comprehensive survivorship care plan because of the risk for both poor
heart disease and cancer outcomes," she said. "Cancer providers don't
have to be solely responsible for talking to survivors about lifestyle
factors, but, if it's noted as part of the wellness goals for that
survivor, then risk factors are more likely to be addressed by the
survivors' treatment team, including primary care."
The findings are published online ahead of print
this month in the Journal of Cancer Survivorship. The research was
supported by the National Cancer Institute at the National Institutes of
Health, N01-PC- 479 35136 and HHSN 261201100189P.
Co-authors include: Randi E. Foraker, M.A., Ph.D.,
The Ohio State University College of Public Health; Catherine M. Alfano,
Ph.D., Julia H. Rowland, Ph.D., Neeraj K. Arora, Ph.D., and Noreen M.
Aziz, M.D., Ph.D., M.P.H., all of NIH; Keith M. Bellizzi, Ph.D., M.P.H.,
University of Connecticut; Ann S. Hamilton, Ph.D., M.A., University of
Southern California; Ingrid Oakley-Girvan, Ph.D., M.P.H., Cancer
Prevention Institute of California; and Gretchen Keel, Information
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