Lung cancer survivors may benefit from screenings for cardiovascular risk, substance abuse

NASHVILLE, Tenn. — Lung cancer survivors had similar or increased frequency of and risk for cardiovascular comorbidities and substance abuse than patients with active lung cancer, according to a presenter at the CHEST Annual Meeting.

Akhil Jain

“Given the growing number of lung cancer survivors, it is important to understand these key clinical factors that impact survivorship,” Akhil Jain, MD, resident physician at Mercy Catholic Medical Center in Darby, Pennsylvania, told Healio.

In this preliminary study involving an analysis of 2016 to 2019 National Inpatient Sample datasets, Jain and colleagues evaluated 2,292,555 adults (18-90 years) with either active lung cancer or who have survived lung cancer to compare the frequency and chances of cardiovascular comorbidities and substance use disorders among both sets of patients.

Within the total cohort, 68.88% (51.21% men; 79.1% white) had active lung cancer, and 31.12% (52.57% women; 83.61% white) were survivors. Lung cancer survivors were significantly older than the survivor group (mean age, 72 years vs. 69 years; P < .001).

Researchers found that lung cancer survivors had more instances of complicated hypertension (29.9% vs. 20.1%), hyperlipidemia (47.7% vs. 39.3%), uncomplicated diabetes (13.2% vs. 12.9%), complicated diabetes (14.8% vs. 11.8%), obesity (9.7% vs. 8%), obstructive sleep apnea (8.4% vs. 5.9%), renal failure (20.6% vs. 13.9%) and hypothyroidism (17.9% vs. 13.2%) than those with active disease.

Additionally, survivors reported higher rates of smoking (54.4% vs. 48.8%), alcohol abuse (4.2% vs. 3.8%) and cocaine use (0.44% vs. 0.4%), according to the abstract.

Univariate analysis showed that compared with those with active lung cancer, survivors of lung cancer faced significantly higher chances for complicated hypertension (OR = 1.7; 95% CI, 1.67-1.72), hyperlipidemia (OR = 1.41; 95% CI, 1.39-1.43), uncomplicated diabetes (OR = 1.02; 95% CI, 1.01-1.05), complicated diabetes (OR = 1.29; 95% CI, 1.27-1.32), obesity (OR = 1.24; 95% CI, 1.21-1.27), obstructive sleep apnea (OR = 1.47; 95% CI, 1.43-1.5), renal failure (OR = 1.6; 95% CI, 1.57-1.63) and hypothyroidism (OR = 1.43; 95% CI, 1.4-1.45).

Lung cancer survivors also had increased odds for smoking (OR = 1.25, 95% CI, 1.23-1.27) and alcohol abuse (OR = 1.1, 95% CI, 1.07-1.15), according to the abstract.

“Although our study focuses on hospitalized patients who are sicker than any other outpatient health care database, the findings indicate that screening for cardiovascular risk factors and addressing substance abuse disorders should be emphasized in lung cancer survivorship programs in order to improve survivorship and possibly reduce hospitalizations,” Jain told Healio.

Reference:

Jain A, et al. Chest. 2022;doi:10.1016/j.chest.2022.08.1442.