Physical activity ‘particularly important’ to reduce CVD risk among AYA cancer survivors
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Certain sociodemographic and modifiable risk factors appeared associated with higher risk for cardiovascular disease among adolescent and young adult cancer survivors, according to research published in Cancer.
“These results highlight the importance of long-term surveillance of AYAs after cancer treatment to ensure that appropriate screenings are initiated to reduce the risk [for] CVD and to promote healthy behavioral changes, such as physical activity, which impact long-term CVD outcomes,” Amy Berkman, MD, of the department of pediatrics at Duke University School of Medicine, said in a press release.
Background, methodology
Approximately 90,000 new cancer diagnoses occur annually among the adolescent and young adult (AYA) population, and the number of AYA cancer survivors in the U.S. is currently estimated to exceed 600,000.
However, a lack of research exists on how sociodemographic and modifiable factors add to the risk for CVD among these young cancer survivors.
To fill this research gap, investigators at Duke University and The University of Texas MD Anderson Cancer Center reviewed 2009 to 2018 National Health Interview Survey responses from 4,766 AYA cancer survivors more than 2 years after diagnosis (median time post diagnosis, 20 years; range, 2-69) and 47,660 individuals without a history of cancer. The survivor and control groups had similar characteristics, including median age (50 years vs. 51 years) and percentages of women (74.1% vs. 75.5%) and white individuals (81.9% vs. 83.2%).
Researchers used logistic regression models to analyze CVD risk among and between the survivor and control groups based on sociodemographic and modifiable risk factors.
Results
Results showed AYA cancer survivors had a significantly higher risk for CVD than individuals in the control group by sex, race/ethnicity, income, education, smoking status and physical activity.
Women in the AYA survivors group appeared nearly twice as likely to develop CVD than women in the control group (OR = 1.81; 95% CI, 1.43-2.29), whereas men in the survivor group had 35% greater odds than men in the control group (OR = 1.35; 95% CI, 0.99-1.83).
Black AYA cancer survivors (OR = 1.93; 95% CI, 1.19-3.13) and those of other races/ethnicities (OR = 2.35; 95% CI, 1.29-4.3) had higher odds of developing CVD when compared with white AYA survivors. Researchers noted no significant difference in the control group in the odds of CVD based on race or ethnicity.
AYA survivors in households with income of more than $50,000 per year had 49% lower odds of developing CVD than survivors in households with income of less than $50,000 per year (OR = 0.51; 95% CI, 0.36-0.71). AYA survivors in households with income of less than $50,000 per year were more than twice as likely to develop CVD as their income counterparts in the control group (OR = 2.13; 95% CI, 1.67-2.72).
Smoking status appeared significantly associated with risk for CVD among both AYA survivors and controls. However, current (OR = 1.75; 95% CI, 1.23-2.49) and former smoking (OR = 1.93; 95% CI, 1.43-2.6) correlated with nearly twofold higher odds among survivors vs. controls with those smoking statuses.
Additionally, increased physical activity — defined as metabolic equivalent-minutes — appeared to lower the odds of CVD for both AYA cancer survivors (OR = 0.61; 95% CI, 0.45-0.81) and controls (OR = 0.68; 95% CI, 0.61-0.77).
Next steps
Researchers noted a need to understand health behavior trajectories among various sociodemographic groups so that opportunities to reduce CVD risk can be identified.
“Performing any [moderate-to-vigorous-intensity physical activity] is particularly important for AYA survivors,” they wrote.
References:
- Berkman AM, et al. Cancer. 2022;doi:10.1002/cncr.34505.
- Young cancer survivors face an elevated risk of developing cardiovascular disease, but study identifies factor that may impact this risk (press release). Available at: newsroom.wiley.com/press-releases/press-release-details/2022/Young-cancer-survivors-face-an-elevated-risk-of-developing-cardiovascular-disease-but-study-identifies-factors-that-may-impact-this-risk-/default.aspx. Published Dec. 5, 2022. Accessed Dec. 5, 2022.
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