Patients with endometrial cancer may require management of pre-existing cardiovascular disease (CVD) and close monitoring of new CVD events, according to researchers.
The team found that patients with endometrial cancer were more likely to have CVD both before and after their cancer diagnosis, when compared with patients who did not have endometrial cancer. These findings were published in Gynecologic Oncology.
This study included 44,386 patients with endometrial cancer and 221,219 patients without endometrial cancer, all of whom were 66 years of age or older. Patients were enrolled in the Surveillance, Epidemiology, and End Results program from 2004 to 2017 and had linked Medicare claims from 2003 to 2018.
At 1 year before diagnosis, patients with endometrial cancer had a significantly higher prevalence of CVD than patients without cancer. This included:
- Ischemic heart disease — 20% in the cancer patients and 15% in the non-cancer patients (P <.001)
- Pulmonary heart disease — 3% and 2%, respectively (P <.001)
- Other heart disease — 34% vs 23% (P <.001)
- Diseases of the arteries, arterioles, and capillaries — 17% vs 13% (P <.001)
- Cerebrovascular disease — 13% vs 10% (P <.001)
- Diseases of the veins and lymphatic system — 7% vs 4% (P <.001).
In a multivariable analysis, the endometrial cancer patients had an increased risk of CVD at 1 year after cancer diagnosis, when compared with the non-cancer patients. This was true for:
- Ischemic heart disease (hazard ratio [HR], 1.18; 95% CI, 1.14-1.21)
- Pulmonary heart disease (HR, 1.41; 95% CI, 1.36-1.46)
- Other forms of heart disease (HR, 1.39; 95% CI, 1.35-1.43)
- Cerebrovascular disease (HR, 1.15; 95% CI, 1.12-1.18)
- Disease of the arteries, arterioles, and capillaries (HR, 1.35; 95% CI, 1.32-1.39)
- Disease of the veins and lymphatic system (HR, 1.95; 95% CI, 1.90-2.01).
In the cancer group, CVD was associated with older age at diagnosis, higher number of comorbidities, Black race, and the presence of hypertension.
“Results of the current study suggest that older women with endometrial cancer have a higher prevalence of CVD-related conditions at the time of their cancer diagnosis, and a higher risk of these conditions after cancer diagnosis, than demographically similar women without a cancer history,” the researchers wrote. “Management of pre-existing CVD and monitoring for new conditions may be critical during endometrial cancer treatment and throughout long-term survivorship.”
Anderson C, Olshan AF, Bae-Jump VL, et al. Cardiovascular disease diagnoses among older women with endometrial cancer. Gynecol Oncol. Published online August 22, 2022. doi:10.1016/j.ygyno.2022.08.014