16 June 2014
Cardiovascular disease has emerged as a serious late effect in survivors of adolescent and young adult cancer
In a recently published study in JNCI among 43 000 cancer survivors, surviving more than 1 year and aged between 15-39 years at diagnose in the period 1943-2009, the risk of cardiovascular disease was quantified in a population-based setting.
Cardiovascular disease in cancer survivors was 30% higher than expected in the general population. The absolute excess risk was 400 extra cases with cardiovascular disease per 100 000 person years amongst those aged 20-59 at the cancer diagnose and as much as 350 per 100 000 person years amongst those aged 60-79.
The authors from the Danish Cancer Research Center, Vanderbilt-Ingram Cancer Center, USA, National Council on Radiation protection and Measurements, USA, Department of Cardiology, Copenhagen University Hospital and Department of Oncology Institute of Clinical Research University of Southern Denmark conclude that cancer survivors in these age groups are at increased risk for cardiovascular disease throughout life with different risk profiles related to the type of cancer they were treated for.
The first author, Katrine Rugbjerg, Danish Cancer Society, underpin that further studies on the exact treatment modalities must follow, but already based on the linked data from the National Patient Register and the Cancer Register, it is clear that long term treatment with chemotherapy and radiation in haematological malignancies, and short and surgical treatment for malignant melanoma give different risk profiles. The current study is an important guide for clinicians in the long term control of cancer patients, enabling early action if cardiovascular side effects of the given treatment emerge.
The Medical Director of the Danish Cancer Society, Hans Storm, welcome the use and link of national health related databases such as the cancer registry and the patient registry holding personal data as such studies give important results highly relevant for patient care and follow-up. He underlines that such a study would be impossible to conduct if each individual has to give permission to the use of personal data which is the current trend in data protection. It is paramount for the quality of such a study and thus for conclusions that there is no doubt about data pertaining to an individual person is linked correct, which today is possible under the current national legislations in the Nordic countries.
The original paper can be found here: http://jnci.oxfordjournals.org/content/106/6/dju110.long