Impact of Cardiovascular Diseases on Mortality in Gastric Cancer Patients with Preexisting Chronic Disease

Yonsei Med J. 2022 Nov;63(11):1043-1049. doi: 10.3349/ymj.2022.0273.

Abstract

Purpose: Chronic diseases and cardiovascular diseases (CVD) have been independently linked to poorer cancer outcomes. This study investigated whether gastric cancer patients with hypertension, diabetes, or dyslipidemia have higher mortality if diagnosed with CVD in the past year before cancer diagnosis.

Materials and methods: Data were obtained from the National Health Insurance database for 2002 to 2019. The study population consisted of gastric cancer patients with hypertension, diabetes, or dyslipidemia. The outcome measure was 5-year mortality in relation to incident status of CVD within 1 year before cancer diagnosis. A survival analysis was conducted using the Cox proportional hazards model. Subgroup analysis was conducted according to age, economic status, and type of hospital first visited for cancer treatment.

Results: Of a total of 6458 individuals, 2123 (32.7%) were diagnosed with CVDs in the past year before cancer diagnosis. Compared to participants without a history of CVD, those who were diagnosed with CVD showed a higher risk of 5-year mortality (hazard ratio 1.259, 95% confidence interval 1.138-1.394). The extent to which the mortality risk differed between those with and without CVD was greater for individuals of low economic status and in those receiving their initial cancer treatment in a general hospital.

Conclusion: Patients with gastric cancer and hypertension, diabetes, or dyslipidemia diagnosed with CVD within 1 year before their cancer diagnosis had a higher mortality risk, emphasizing the importance of managing cancer patients with chronic disease and subsequent incidence of CVDs.

Keywords: Cardiovascular disease; chronic disease; gastric cancer; mortality.

MeSH terms

  • Cardiovascular Diseases* / complications
  • Cardiovascular Diseases* / epidemiology
  • Chronic Disease
  • Diabetes Mellitus* / epidemiology
  • Dyslipidemias* / complications
  • Dyslipidemias* / epidemiology
  • Humans
  • Hypertension* / epidemiology
  • Proportional Hazards Models
  • Risk Factors
  • Stomach Neoplasms* / complications
  • Stomach Neoplasms* / epidemiology