Publication:
Incident Cardiovascular Diseases Among Survivors of High-Risk Stage II-III Colorectal Cancer: A Cluster-Wide Cohort Study.

dc.contributor.authorLee, Shing Fung
dc.contributor.authorYip, Pui Lam
dc.contributor.authorVellayappan, Balamurugan A
dc.contributor.authorChee, Cheng Ean
dc.contributor.authorWong, Lea Choung
dc.contributor.authorWan, Eric Yuk-Fai
dc.contributor.authorChan, Esther Wai-Yin
dc.contributor.authorLee, Chak-Fei
dc.contributor.authorLee, Francis Ann-Shing
dc.contributor.authorLuque-Fernandez, Miguel Angel
dc.date.accessioned2023-05-03T14:27:36Z
dc.date.available2023-05-03T14:27:36Z
dc.date.issued2022
dc.description.abstractThe incidence and survival of colorectal cancer (CRC) are increasing. There is an increasing number of long-term survivors, many of whom are elderly and have comorbidities. We conducted a population-based study in Hong Kong to assess the long-term cardiovascular disease (CVD) incidence associated with adjuvant fluoropyrimidine-based chemotherapy among CRC survivors. Using the population-based electronic medical database of Hong Kong, we identified adults who were diagnosed with high-risk stage II-III CRC and treated with radical surgery followed by adjuvant fluoropyrimidine-based chemotherapy between 2010 and 2019. We evaluated the cause-specific cumulative incidence of CVD (including ischemic heart disease, heart failure, cardiomyopathy, and stroke) using the flexible parametric competing risk modeling framework. The control group without a history of CVD was selected from among a noncancer random sample from primary care clinics in the same geographic area. We analyzed 1,037 treated patients with CRC and 5,078 noncancer controls. The adjusted cause-specific hazard ratio (HR) for CVD in the cancer cohort compared with the control group was 2.11 (95% CI, 1.39-3.20). The 1-, 5-, and 10-year cause-specific cumulative incidences were 2.0%, 4.5%, and 5.4% in the cancer cohort versus 1.2%, 3.0%, and 3.8% in the control group, respectively. Age at cancer diagnosis (HR per 5-year increase, 1.16; 95% CI, 1.08-1.24), male sex (HR, 1.40; 95% CI, 1.06-1.86), comorbidity (HR, 1.88; 95% CI, 1.36-2.61 for 1 comorbidity vs none, and HR, 6.61; 95% CI, 4.55-9.60 for ≥2 comorbidities vs none), diabetes (HR, 1.38; 95% CI, 1.04-1.84), hypertension (HR, 3.27; 95% CI, 2.39-4.50), and dyslipidemia/hyperlipidemia (HR, 2.53; 95% CI, 1.68-3.81) were associated with incident CVD. Exposure to adjuvant fluoropyrimidine-based chemotherapy was associated with an increased risk of CVD among survivors of high-risk stage II-III CRC. Cardiovascular risk monitoring of this group throughout cancer survivorship is advisable.
dc.identifier.doi10.6004/jnccn.2022.7042
dc.identifier.essn1540-1413
dc.identifier.pmid36240841
dc.identifier.unpaywallURLhttps://jnccn.org/downloadpdf/journals/jnccn/20/10/article-p1125.pdf
dc.identifier.urihttp://hdl.handle.net/10668/21669
dc.issue.number10
dc.journal.titleJournal of the National Comprehensive Cancer Network : JNCCN
dc.journal.titleabbreviationJ Natl Compr Canc Netw
dc.language.isoen
dc.organizationEscuela Andaluza de Salud Pública-EASP
dc.page.number1125-1133.e10
dc.pubmedtypeJournal Article
dc.rights.accessRightsopen access
dc.subjectcardiovascular diseases
dc.subjectchemotherapy
dc.subjectcolorectal cancer
dc.subjectcompeting risk
dc.subjectsurvivors
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshCardiovascular Diseases
dc.subject.meshCohort Studies
dc.subject.meshColorectal Neoplasms
dc.subject.meshHumans
dc.subject.meshIncidence
dc.subject.meshMale
dc.subject.meshRisk Factors
dc.subject.meshSurvivors
dc.titleIncident Cardiovascular Diseases Among Survivors of High-Risk Stage II-III Colorectal Cancer: A Cluster-Wide Cohort Study.
dc.typeresearch article
dc.type.hasVersionVoR
dc.volume.number20
dspace.entity.typePublication
Files