A new study in the Journal of the National Cancer Institute indicates that survivors of uterine cancer are more likely to experience cardiovascular problems years after treatment.
Endometrial (uterine) cancer is the fourth most commonly diagnosed cancer among women in the United States. Incidence rates among women under the age of 50 have been increasing by 1.3% per year since 1988 and by 1.9% among women over the age of 50 since 2005. It was the 6th most common cause of death from cancer among women in the United States in 2017, with an estimated 10,920 deaths. As of 2017, there were an estimated 757,200 endometrial cancer survivors in the United States.
Previous studies of long-term health effects among endometrial cancer survivors have focused largely on quality of life, mental health, obesity, and adverse sexual side effects. But the high overall survival rate among people diagnosed with the cancer, the projected increase in the number of such cancer diagnoses, the introduction of more complex therapies, and the high mortality due to cardiovascular disease among endometrial cancer survivors, suggest that other long-term health effects are important to assess.
Researchers here identified 3,621 endometrial cancer survivors using the Utah Population Database. Diagnosis data was available for women aged 18 and over diagnosed with this cancer between 1997 and 2012 in Utah.
The results of the study indicate that approximately 25.7% of cancer survivors were diagnosed with heart diseases five to ten years after cancer diagnosis. Endometrial cancer survivors were 47% more likely to be diagnosed with a disease of the heart between one of five years after cancer diagnosis and 33% more likely to be diagnosed with a disease of the heart between five to ten years after the initial cancer diagnosis.
Researchers observed elevated risk during the one-to-five-year time period for peripheral and vascular atherosclerosis, hypotension, phlebitis, thrombophlebitis, thromboembolism, other circulatory diseases, and other diseases of the veins and lymphatics. Researchers found associations for hypotension, diseases of veins and lymphatics, and other diseases of veins and lymphatics.
Between one to five years after diagnosis, researchers observed increased cardiovascular risks among endometrial cancer survivors for phlebitis, thrombophlebitis and thromboembolism, lymphatic diseases, pulmonary heart disease, and atrial fibrillation. Some elevated risk persisted for cardiovascular diseases at five to ten years. Compared to patients who had surgery, patients who additionally had radiation therapy and/or chemotherapy were at increased risk for heart and circulatory system disorders between one to five years after cancer diagnosis.
Prior studies have reported similar proportions of endometrial cancer survivors who have hypertension diagnoses, but this study is the first to quantify risk for hypertension after cancer diagnosis among uterine cancer survivors compared to the general population.
This study suggests that increased monitoring for cardiovascular diseases may be important for endometrial cancer patients for 10 years after cancer diagnosis.
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The paper, "Long-term cardiovascular outcomes among endometrial cancer survivors in a large, population-based cohort study," will be available at: https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djy070
Direct correspondence to:
Mia Hashibe, Ph.D.
University of Utah School of Medicine
2000 Circle of Hope
Salt Lake City, UT, 84112
mia.hashibe@utah.edu
To request a copy of the study, please contact:
Daniel Luzer
daniel.luzer@oup.com
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Journal
JNCI Journal of the National Cancer Institute