Cardiovascular late effects among endometrial cancer survivors in a cohort study.

摘要: 131 Background: Endometrial cancer is the second most common cancer among female cancer survivors in the US, with an estimated 757,000 endometrial cancer survivors in 2016. Cardiovascular disease is the leading cause of death among endometrial cancer survivors. Cardiovascular disease risk may be increased among endometrial cancer survivors due to shared risk factors such as obesity or because of cancer treatment. Because of the high overall survival rate and the large number of endometrial cancer survivors, studies that examine late effects among endometrial cancer survivors are critical. Methods: Cohorts of 3,337 endometrial cancer survivors diagnosed between 1997 and 2012, and 19,420 age-matched cancer-free women were identified using the Utah Population Database. All ICD-9 diagnosis codes were collected from the state’s two largest healthcare systems and statewide ambulatory surgery and inpatient visits. Diagnoses were collapsed into cardiovascular system disorders according to the Healthcare Cost and Utilization Project’s Clinical Classification Software. Cox regression models were used to estimate hazard ratios (HR) at 1-5 years and 5-10 years after cancer diagnosis. Models were adjusted for race/ethnicity, baseline BMI, and baseline Charlson Comorbidity Index. Results: Approximately 89.4% of cancer cases were diagnosed with stage I or stage II disease. At 1-5 years after diagnosis, the highest risks among endometrial cancer survivors were observed for phlebitis and thrombophlebitis (HR: 3.36, 99% CI: 1.96-5.77), lymphatic diseases (HR: 1.89, 99% CI: 1.64-2.19), pulmonary heart disease (HR: 1.82, 99% CI: 1.36-2.43), hypotension (HR: 1.64, 99% CI: 1.18-2.29), and atrial fibrillation (HR: 1.61, 99% CI: 1.25-2.06). At 5-10 years, elevated risk persisted for these and 17 out of 66 additional outcomes among the endometrial cancer survivors. Conclusions: Endometrial cancer survivors in this population are at higher risk for various long term cardiovascular outcomes compared to cancer-free women. This study presents sufficient evidence to suggest that increased monitoring is necessary for women diagnosed with endometrial cancer in the first several years after diagnosis, and out to ten years as well.