|The following article features coverage from the American Society of Clinical Oncology 2019 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.|
Elderly patients with breast cancer are more likely to visit the emergency room (ER) if they have risk factors for cardiovascular disease (CVD-RFs), according to a study that was presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois.
While it is known that CVD-RFs predict cardiac events among patients with breast cancer receiving chemotherapy, whether these factors affect health care utilization and costs in the United States was previously unknown. For this study, researchers evaluated data from patients treated for breast cancer on a SWOG trial between 1999 and 2011. CVD-RFs included baseline diabetes, hypertension, hypercholesterolemia, and coronary artery disease (CAD) or ischemic heart disease; the study’s outcomes were ER visits, hospitalizations, and health care costs.
Among the 708 evaluated patients, 193 (27.3%, 311 total visits) visited the ER and 160 patients (22.6%, 234 total hospitalizations) were hospitalized. All evaluated CVD-RFs were linked to a greater risk of hospitalization and ER visit; hypertension, however, carried the greatest risk, “with more than a 3-fold risk of hospitalization for those with hypertension compared to those without,” according to the authors. Patients with at least 3 CVD-RFs were, furthermore, more than twice as likely to be hospitalized as those with 0 or 1 (odds ratio, 2.74; P <.001) — with similar results for ER visits.
Costs among patients with CVD-RFs were also higher than among those without these risk factors. Within the first year after enrollment in a clinical trial, patients with diabetes, hypercholesterolemia, or CAD had 23.9%, 11.4%, and 19.2% increased costs, respectively, compared with those without CVD-RFs.
“Our study demonstrates that the presence of both CVD-RFs and ER visits and hospitalizations are frequent among elderly [breast cancer] patients,” the authors wrote. “Better management of CVD-RFs and more aggressive symptom management may be required to reduce both physical and financial toxicities to elderly patients undergoing BC therapy.”
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Hershman DL, Till C, Wright JD, et al. Association of baseline cardiovascular risk factors and health care utilization and costs in elderly breast cancer patients enrolled in SWOG clinical trials. Presented at: 2019 American Society of Clinical Oncology (ASCO) Annual Meeting; May 31-June 4, 2019; Chicago, IL. Abstract 11508.