Cardiac Mortality Among 200 000 Five-Year Survivors of Cancer Diagnosed at 15 to 39 Years of Age: The Teenage and Young Adult Cancer Survivor Study
Authors' conclusion
This study of over 200 000 cancer survivors shows that age at cancer diagnosis was critical in determining subsequent cardiac mortality risk.
Study context
- Population
- 5-year survivors of cancer diagnosed at 15 to 39 years of age, England and Wales, 1971–2006, followed to 20142,016 cardiac deaths
- Participants
- 200,945 survivors
- Exposure
- 15 to 19 years vs 35 to 39 years
- Outcome
- Cardiac mortality (standardized mortality ratios, absolute excess risks, cumulative risks)
Main finding
As reported in the abstract
All cardiac diseases, all cancers combined, by age at diagnosis
15 to 19 years
4.2
SMR · 95% CI 3.4–5.2
35 to 39 years
1.2
SMR · 95% CI 1.1–1.3
- Trend across age at diagnosis
- 2P for trend <0.0001
Observational data: associations, not effects.
Further findings
Ischemic heart disease, valvular heart disease, cardiomyopathy
- Similar patterns by age for SMRs and absolute excess risks
Cardiac deaths vs expected (SMR), by cancer type
- Hodgkin lymphoma
- 3.8
- Acute myeloid leukaemia
- 2.7
- Genitourinary cancers other than bladder
- 2.0
- Non-Hodgkin lymphoma
- 1.7
- Lung cancer
- 1.7
- Leukaemia other than acute myeloid
- 1.6
- CNS tumour
- 1.4
- Cervical cancer
- 1.3
- Breast cancer
- 1.2
- Times the number of cardiac deaths expected from the general population
Hodgkin lymphoma survivors aged over 60 years: share of excess deaths due to heart disease
- Excess deaths due to heart disease
- almost 30%
Original publication
Cardiac Mortality Among 200 000 Five-Year Survivors of Cancer Diagnosed at 15 to 39 Years of Age: The Teenage and Young Adult Cancer Survivor Study. Circulation. Published 7 November 2016. doi:10.
Summarised from the published abstract; every number is checked against it