Survival of cancer patients with pre-existing heart disease.


Journal

BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800

Informations de publication

Date de publication:
03 Aug 2022
Historique:
received: 28 04 2022
accepted: 27 07 2022
entrez: 3 8 2022
pubmed: 4 8 2022
medline: 6 8 2022
Statut: epublish

Résumé

While cancer outcomes have improved over time, in Northern Ireland they continue to lag behind those of many other developed economies. The role of comorbid conditions has been suggested as a potential contributory factor in this but issues of data comparability across jurisdictions has inhibited efforts to explore relationships. We use data from a single jurisdiction of the UK using data from - the Northern Ireland Cancer Registry (NICR), to examine the association between mortality (all-cause and cancer specific) and pre-existing cardiovascular diseases among patients with cancer. All patients diagnosed with cancer (excluding non-melanoma skin cancer) between 2011 and 2014 were identified from Registry records. Those with a pre-existing diagnosis of cardiovascular diseases were identified by record linkage with patient hospital discharge data using ICD10 codes. Survival following diagnosis was examined using descriptive statistics and Cox proportional hazards regression analyses. Analyses examined all-cause mortality and cancer specific mortality for lung, colorectal, breast and prostate cancer. As well as cardiovascular diseases, regression models controlled for age, gender (where appropriate), deprivation (as quintiles), stage at diagnosis and other comorbidities. Almost 35,000 incident cancer cases were diagnosed during the study period of which approximately 23% had a prior heart condition. The pan-cancer hazard ratio for death in the presence of pre-existing cardiovascular diseases was 1.28 (95% CI: 1.18-1.40). All-cause and cancer specific mortality was higher for patients with cardiovascular diseases across lung, female breast, prostate and colorectal cancer groups after controlling for age, gender (where appropriate), deprivation (as quintiles), stage at diagnosis and other comorbidities. Pre-existing morbidity may restrict the treatment of cancer for many patients. In this cohort, cancer patients with pre-existing cardiovascular diseases had poorer outcomes than those without cardiovascular diseases. A high prevalence of cardiovascular diseases may contribute to poorer cancer outcomes at a national level.

Sections du résumé

BACKGROUND BACKGROUND
While cancer outcomes have improved over time, in Northern Ireland they continue to lag behind those of many other developed economies. The role of comorbid conditions has been suggested as a potential contributory factor in this but issues of data comparability across jurisdictions has inhibited efforts to explore relationships. We use data from a single jurisdiction of the UK using data from - the Northern Ireland Cancer Registry (NICR), to examine the association between mortality (all-cause and cancer specific) and pre-existing cardiovascular diseases among patients with cancer.
MATERIALS AND METHODS METHODS
All patients diagnosed with cancer (excluding non-melanoma skin cancer) between 2011 and 2014 were identified from Registry records. Those with a pre-existing diagnosis of cardiovascular diseases were identified by record linkage with patient hospital discharge data using ICD10 codes. Survival following diagnosis was examined using descriptive statistics and Cox proportional hazards regression analyses. Analyses examined all-cause mortality and cancer specific mortality for lung, colorectal, breast and prostate cancer. As well as cardiovascular diseases, regression models controlled for age, gender (where appropriate), deprivation (as quintiles), stage at diagnosis and other comorbidities.
RESULTS RESULTS
Almost 35,000 incident cancer cases were diagnosed during the study period of which approximately 23% had a prior heart condition. The pan-cancer hazard ratio for death in the presence of pre-existing cardiovascular diseases was 1.28 (95% CI: 1.18-1.40). All-cause and cancer specific mortality was higher for patients with cardiovascular diseases across lung, female breast, prostate and colorectal cancer groups after controlling for age, gender (where appropriate), deprivation (as quintiles), stage at diagnosis and other comorbidities.
CONCLUSION CONCLUSIONS
Pre-existing morbidity may restrict the treatment of cancer for many patients. In this cohort, cancer patients with pre-existing cardiovascular diseases had poorer outcomes than those without cardiovascular diseases. A high prevalence of cardiovascular diseases may contribute to poorer cancer outcomes at a national level.

Identifiants

pubmed: 35922767
doi: 10.1186/s12885-022-09944-z
pii: 10.1186/s12885-022-09944-z
pmc: PMC9351236
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

847

Informations de copyright

© 2022. The Author(s).

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Auteurs

Ciaran O'Neill (C)

Northern Ireland Cancer Registry, Belfast, UK. ciaran.oneill@qub.ac.uk.
Centre for Public Health, Queens University Belfast, Belfast, UK. ciaran.oneill@qub.ac.uk.

David W Donnelly (DW)

Northern Ireland Cancer Registry, Belfast, UK.

Mark Harbinson (M)

School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK.

Therese Kearney (T)

Centre for Public Health, Queens University Belfast, Belfast, UK.

Colin R Fox (CR)

Northern Ireland Cancer Registry, Belfast, UK.

Gerard Walls (G)

Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK.
Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, Belfast, UK.

Anna Gavin (A)

Northern Ireland Cancer Registry, Belfast, UK.

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Classifications MeSH