Social disparities in cardiovascular mortality of patients with cancer in the USA between 1999 and 2019.
Cardio-oncology
Race
Social determinants of health
Urbanisation
Women's health
Journal
International journal of cardiology. Cardiovascular risk and prevention
ISSN: 2772-4875
Titre abrégé: Int J Cardiol Cardiovasc Risk Prev
Pays: Netherlands
ID NLM: 9918282077306676
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
14
04
2023
revised:
30
08
2023
accepted:
28
09
2023
medline:
16
10
2023
pubmed:
16
10
2023
entrez:
16
10
2023
Statut:
epublish
Résumé
Temporal trends of the impact of social determinants on cardiovascular outcomes of cancer patients has not been previously studied. This study examined social disparities in cardiovascular mortality of people with and without cancer in the US population between 1999 and 2019. Primary cardiovascular deaths were identified from the Multiple Cause of Death database and grouped by cancer status. The cancer cohort was subcategorized into breast, lung, prostate, colorectal, and haematological. The number of cardiovascular deaths, crude cardiovascular mortality rate, cardiovascular age-adjusted mortality rate (AAMR), and percentage change in cardiovascular AAMR were calculated by cancer status and cancer type, and stratified by sex, race, ethnicity, and urban-rural setting. 17.9 million cardiovascular deaths were analysed. Of these, 572,222 occurred in patients with a record of cancer. The cancer cohort were older and included more men and White racial groups. Regardless of cancer status, cardiovascular AAMR was higher in men, rural settings, and Black or African American races. Cardiovascular AAMR declined over time, with greater reduction in those with cancer (-51.6% vs -38.3%); the greatest reductions were in colorectal (-68.4%), prostate (-60.0%), and breast (-58.8%) cancers. Sex, race, and ethnic disparities reduced over time, with greater narrowing in the cancer cohort. There was increase in urban-rural disparities, which appeared greater in those with cancer. While most social disparities narrowed over time, urban-rural disparities widened, with greater increase in those with cancer. Healthcare plans should incorporate strategies for reduction of health inequality equitable access to cardio-oncology services.
Sections du résumé
Background
UNASSIGNED
Temporal trends of the impact of social determinants on cardiovascular outcomes of cancer patients has not been previously studied.
Objectives
UNASSIGNED
This study examined social disparities in cardiovascular mortality of people with and without cancer in the US population between 1999 and 2019.
Methods
UNASSIGNED
Primary cardiovascular deaths were identified from the Multiple Cause of Death database and grouped by cancer status. The cancer cohort was subcategorized into breast, lung, prostate, colorectal, and haematological. The number of cardiovascular deaths, crude cardiovascular mortality rate, cardiovascular age-adjusted mortality rate (AAMR), and percentage change in cardiovascular AAMR were calculated by cancer status and cancer type, and stratified by sex, race, ethnicity, and urban-rural setting.
Results
UNASSIGNED
17.9 million cardiovascular deaths were analysed. Of these, 572,222 occurred in patients with a record of cancer. The cancer cohort were older and included more men and White racial groups. Regardless of cancer status, cardiovascular AAMR was higher in men, rural settings, and Black or African American races. Cardiovascular AAMR declined over time, with greater reduction in those with cancer (-51.6% vs -38.3%); the greatest reductions were in colorectal (-68.4%), prostate (-60.0%), and breast (-58.8%) cancers. Sex, race, and ethnic disparities reduced over time, with greater narrowing in the cancer cohort. There was increase in urban-rural disparities, which appeared greater in those with cancer.
Conclusions
UNASSIGNED
While most social disparities narrowed over time, urban-rural disparities widened, with greater increase in those with cancer. Healthcare plans should incorporate strategies for reduction of health inequality equitable access to cardio-oncology services.
Identifiants
pubmed: 37841449
doi: 10.1016/j.ijcrp.2023.200218
pii: S2772-4875(23)00051-X
pmc: PMC10568337
doi:
Types de publication
Journal Article
Langues
eng
Pagination
200218Informations de copyright
© 2023 The Authors. Published by Elsevier B.V.
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