Disparities in Cardiovascular Disease Risk Among Hispanic Breast Cancer Survivors in a Population-Based Cohort

Author:

Hu Qingqing12,Chang Chun-Pin12ORCID,Rowe Kerry3ORCID,Snyder John3,Deshmukh Vikrant4,Newman Michael4ORCID,Fraser Alison5ORCID,Smith Ken5,Gren Lisa H1ORCID,Porucznik Christina1ORCID,Stanford Joseph B1ORCID,Gaffney David26,Henry N Lynn7ORCID,Lopez Ivette1,Hashibe Mia128ORCID

Affiliation:

1. Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA

2. Huntsman Cancer Institute, Salt Lake City, UT, USA

3. Intermountain Healthcare, Salt Lake City, UT, USA

4. University of Utah Health Sciences Center, Salt Lake City, UT, USA

5. Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA

6. Department of Radiation Oncology, University of Utah, Salt Lake City, UT, USA

7. Division of Hematology/Oncology, University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA

8. Utah Cancer Registry, Salt Lake City, UT, USA

Abstract

Abstract Background Breast cancer is the leading cause of cancer death among Hispanic women. The aim of our study was to estimate cardiovascular disease (CVD) risk among Hispanic and non-Hispanic White (NHW) breast cancer survivors compared with their respective general population cohorts. Methods Cohorts of 17 469 breast cancer survivors (1774 Hispanic and 15 695 NHW) in the Utah Cancer Registry diagnosed between 1997 and 2016, and 65 866 women (6209 Hispanic and 59 657 NHW) from the general population in the Utah Population Database were identified. Cox proportional hazards models were used to estimate hazard ratios (HRs) for CVD. Results The risk of diseases of the circulatory system was higher in Hispanic than NHW breast cancer survivors 1-5 years after cancer diagnosis, in comparison with their respective general population cohorts (HRHispanic = 1.94, 99% confidence interval [CI] = 1.49 to 2.53; HNHW = 1.38, 99% CI = 1.33 to 1.43; 2-sided Pheterogeneity = .01, respectively). Increased risks were observed for both Hispanic and NHW breast cancer survivors for diseases of the heart and the veins and lymphatics, compared with the general population cohorts. More than 5 years after cancer diagnosis, elevated risk of diseases of the veins and lymphatics persisted in both ethnicities. The CVD risk due to chemotherapy and hormone therapy was higher in Hispanic than NHW breast cancer survivors but did not differ for distant stage, higher baseline comorbidities, or baseline smoking. Conclusions We observed a risk difference for diseases of the circulatory system between Hispanic and NHW breast cancer survivors compared with their respective general population cohorts but only within the first 5 years of cancer diagnosis.

Funder

NCI

Department of Family and Preventive Medicine at the University of Utah and the NCRR

Sharing Statewide Health Data for Genetic Research

Utah State Department of Health and the University of Utah

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Oncology

Reference49 articles.

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