Risk factors for cardiovascular disease in 5-year survivors of adolescent and young adult cancer: A Danish population-based cohort study

Cancer. 2020 Feb 1;126(3):659-669. doi: 10.1002/cncr.32580. Epub 2019 Nov 12.

Abstract

Background: An increased risk of metabolic syndrome has been reported for childhood cancer survivors and for adult survivors with certain cancer types. One previous study reported on the risk for diseases in the metabolic syndrome specifically among survivors of adolescent and young adult cancers.

Methods: The study comprised 11,822 five-year survivors of adolescent and young adult cancer (ages 15-39 years at diagnosis) who were diagnosed during the period from 1994 through 2009 in Denmark and a population-based comparison cohort of 76,024 individuals. The cohorts were linked to Danish nationwide registries for information on hospital contacts and purchase of prescription drugs related to metabolic syndrome, respectively. Standardized rate ratios (RRs) for hospital contacts (SHRRs) and prescriptions (SPRRs) with 95% CIs were calculated for diabetes, hyperlipidemia, and hypertension.

Results: Survivors had increased risks for hospital contacts and prescriptions for diabetes (SHRR, 1.21; 95% CI, 1.03-1.43; SPRR, 1.08; 95% CI, 0.96-1.23), hyperlipidemia (SHRR, 1.18; 95% CI, 1.00-1.40; SPRR, 1.16; 95% CI, 1.08-1.25), and hypertension (SHRR, 1.27; 95% CI, 1.15-1.41; SPRR, 1.25; 95% CI, 1.20-1.31). The highest risks for hospitalizations were among survivors of brain cancer (RR, 2.94 for diabetes) and Hodgkin lymphoma (RR, 2.40 for diabetes). Survivors of brain cancer and Hodgkin lymphoma were most likely to purchase prescription drugs for diseases in metabolic syndrome.

Conclusions: Survivors of adolescent and young adult cancer are at increased risk of hospital contacts and purchase of prescription drugs for diseases in metabolic syndrome. Survivors at high risk should be followed closely to improve prevention, early detection, and management of these diseases to ultimately minimize the risk of cardiovascular diseases.

Keywords: adolescents and young adults; diabetes; hyperlipidemia; hypertension; metabolic syndrome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Brain Neoplasms / complications
  • Brain Neoplasms / epidemiology*
  • Brain Neoplasms / pathology
  • Cancer Survivors
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / pathology
  • Child
  • Denmark / epidemiology
  • Female
  • Hodgkin Disease / complications
  • Hodgkin Disease / epidemiology*
  • Hodgkin Disease / pathology
  • Humans
  • Male
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / epidemiology*
  • Metabolic Syndrome / pathology
  • Risk Assessment
  • Risk Factors
  • Young Adult