06 September 2019

A Canadian study has identified further links between cancer in childhood and a range of cardiovascular diseases.

A team led by Dr Paul Nathan, at The Hospital for Sick Children (SickKids) in Ontario, Canada, examined the risks of a variety of cardiovascular disease. Most previous studies have focused solely on anthracycline-related heart failure only.

The team evaluated the predictors of heart failure, arrhythmias, pericardial disease, valvular disease, and coronary artery disease in nearly 7,300 childhood cancer survivors on an Ontario register.

Participants had all survived for more than five years after a cancer diagnosis below the age of 18. Their health information was compared against that of more than 36,000 similar cancer-free individuals.

During an average of ten years of follow-up, 2.8% of the cancer survivors experienced one or more cardiac events, compared with 0.9% of matched cancer-free individuals.

This equates to 3.2 cardiac events per 1,000 person-years in cancer survivors, versus 0.9 cardiac events per 1,000 person-years in the general population.

Sharing their results in the journal Circulation, the team wrote: “Because the prevalence of cardiovascular disease is expected to increase with age, this study reinforces the need for periodic cardiovascular disease surveillance, and consideration of all cardiovascular disease types, in childhood cancer survivors.”

Dr Nathan said: “While anthracycline chemotherapy may induce heart disease, many patients require this cancer treatment to survive. Doctors should address heart disease risk factors – such as diabetes and hypertension – that can be modified.

“The close connections between lifestyle, metabolic disorders and cardiac disease warrant careful follow-up and monitoring of the childhood cancer survivor population.”

Source: Khanna, A., Pequeno, P., Gupta, S., Thavendiranathan, P., Lee, D.S., Abdel-Qadir, H., Nathan, P.C. (2019) “Increased Risk of All Cardiovascular Disease Subtypes Among Childhood Cancer Survivors: Population-Based Matched Cohort Study”, Circulation, available from doi: 10.1161/CIRCULATIONAHA.119.041403


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