Cancer Education

Cancer and cardiovascular disease, the main causes of death

Cardiovascular disease and cancer are the leading causes of mortality, both in our country and the rest of the world.

In 2016, in USA, 119,778 deaths were due to cardiovascular diseases, while, very closely, 112,939 deaths were caused by cancer.

Worldwide, according to WHO data, 17.9 million deaths were due to cardiovascular disease in 2016, representing 31.1% of all deaths. Regarding cancer, there were 9.6 million deaths in 2018.

Study on cardiovascular risk and cancer

This new study, carried out by researchers from different centers in the United States, was recently published in the European Heart Journal.

It is the largest and most comprehensive study to date on cardiovascular mortality in cancer patients. It covers up to 28 different types of cancer with data collected over 40 years.

Specifically, data was collected from 3,234,256 cancer patients registered between 1973 and 2012. In this representative sample, 49.3% of the patients died of cancer or cardiovascular disease during this period. Cardiovascular mortality data for cancer survivors were compared with the general population.

Study results

The standardized mortality rate was calculated using the cause of death from cardiovascular disease (heart disease, hypertension, cerebrovascular disease, atherosclerosis, and aneurysm). The analyzes were adjusted for different variables such as age, race, and sex. Among cancer patients, 1,228,328 (38.0%) died of one of the 28 tumor types. In contrast, 365,689 patients (11.3%) died of cardiovascular disease, of which 76.3% were heart disease.

Most deaths from cardiovascular disease occur in patients diagnosed with breast, prostate, or bladder cancer. For patients with cancers of the penis, vulva, bladder, endometrium, prostate, testicle, thyroid, or Hodgkin’s lymphoma, there is a year-to-year variation in the leading cause of death (cardiovascular or cancer).

On the other hand, the risk of mortality from cardiovascular disease was higher in survivors diagnosed with less than 35 years of age. Furthermore, the risk of mortality from cardiovascular disease was 4 times higher within the first year after the cancer diagnosis, representing the highest risk (standardized risk of mortality = 3.93, 95% CI = 3.89-3, 97).

Finally, the risk of mortality from cardiovascular disease was higher after the first year compared to the general population.

Causes of increased risk of cardiovascular mortality

Little is investigated in the study about the causes of the increased risk of mortality in cancer patients. A possible explanation is cited based on the more aggressive treatments that are usually given immediately after a cancer diagnosis. The long period with a high cardiovascular risk is also mentioned, once cancer has been overcome.

Cardiology care in cancer patients

Long-term care related to cancer survival is an area in which the responsibilities of primary care physicians and specialists (oncologists, cardiologists, etc.) must be well defined.

Thus, primary care physicians must be responsible for the prevention, while cardiologists must supervise the management of cardiovascular diseases once they appear.

In this context, the elevated cardiovascular risk faced by cancer survivors has been underestimated to date. As a result, the opportunity to intervene early on this risk or to consider less cardiovascularly aggressive cancer treatment options has been lost.

Regarding prevention, one of the most useful and effective strategies continues to be the modification of traditional cardiovascular risk factors (diet, physical activity, blood pressure, etc.).

In short, in patients diagnosed with cancer, it would be advisable to pay special cardio logical care. Especially in patients with laryngeal and endometrial cancer, since this type of tumor have a good prognosis, but a relatively high risk of mortality from cardiovascular disease, particularly in the first year after diagnosis.

Study conclusions

From the moment of diagnosis, cancer patients have a higher risk of dying from cardiovascular disease compared to the general population.

The results of the study highlight the need for early and effective cardiovascular care in cancer patients, which implies a coordinated action between oncologists, cardiologists, and primary care physicians.