Risk of Cardiovascular Morbidity in Older Adults With Colorectal Cancer
Posted: Wednesday, May 23, 2018
Older patients with colorectal cancer are at an increased risk of developing cardiovascular disease and congestive heart failure, according to a study led by Kelly Kenzik, MS, PhD, of the University of Alabama at Birmingham (UAB). The 10-year cumulative onset of new cardiovascular diseases was significantly greater in those with colorectal cancer versus those without. The results, published in the Journal of Clinical Oncology, also show that diabetes and hypertension interact with chemotherapy treatment and increase a patient’s risk for cardiovascular morbidity.
“This study fundamentally changes the discussion around short-term and long-term chemotherapy outcomes, as the effects of treatment on the development of other conditions have not been studied in a systematic way before,” said Dr. Kenzik in a UAB press release. “If we can recognize the long-term effects of specific chemotherapy agents on patient conditions, we can better support and treat those patients from the start of their treatment.”
The researchers used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to evaluate patients with incident stages I to III colorectal cancer who were 65 years of age or older (n = 72, 408). They compared these patients with a control cohort of Medicare patients without cancer (n= 72,408).
The 10-year cumulative incidence of new-onset cardiovascular disease or congestive heart failure was 57.4% and 54.5% in the patient group compared with 22% and 18% in the control group, respectively. The interaction between hypertension and chemotherapy was significant for both cardiovascular disease, as was the interaction between diabetes and chemotherapy (both P < .001). In addition, exposure to capecitabine alone increased congestive heart failure hazard within the first 2 years of diagnosis. In contrast, those treated with fluorouracil alone seemed to have a higher cardiovascular disease hazard up to 2 years and after 2 years since diagnosis, compared with those who received capecitabine alone.