Department of Social and Behavioural Sciences, Harvard School of Public Health, Harvard University, Boston, MA, USA.
J Intern Med. 2014 May;275(5):494-505. doi: 10.1111/joim.12165. Epub 2013 Dec 21.
Cardiovascular disease (CVD) and cancer are the two leading causes of death in the United States; at the same time, the number of survivors is increasing as therapies continue to improve. The primary objective of this study is to determine the prevalence and characteristics of individuals affected by both CVD and cancer.
We conducted a prevalence study using the 2009 and 2010 national Behavioural Risk Factor Surveillance System population survey. Data from a random sample of individuals (aged 25-99 years) from all states were collected. All participants provided information regarding their CVD and cancer status. Multivariable regression identified associations between participants' characteristics and the prevalence of double disease burden.
Amongst 442,964 study participants, the overall prevalence rates were 11% for CVD and 15% for cancer; 3% of participants reported being survivors of both CVD and cancer. The prevalence of CVD+cancer increased twofold by 65 years of age (odds ratio [OR] 2.4, 95% confidence interval [CI] 2.3-2.5) and doubled again at ≥75 years (OR 4.9, 95% CI 4.6-5.1) and was higher amongst men (OR 1.6, 95% CI 1.6-1.7), multiracial individuals (OR 1.8, 95% CI 1.5-2.0) and those without a high school diploma (OR 1.3, 95% CI 1.2-1.4). Amongst individuals with CVD, 25% also reported having cancer, whilst 19% of all cancer survivors reported having CVD.
The prevalence of the double burden of disease increased with age; this is particularly important as the 'baby boomers' reach this high-risk age group. Future studies should explore potential common upstream or downstream mechanisms of CVD and cancer as well as public health strategies to cope with the double burden of disease.
心血管疾病（CVD）和癌症是美国的两大主要死亡原因；同时，随着治疗方法的不断改进，幸存者的数量也在增加。本研究的主要目的是确定同时患有 CVD 和癌症的个体的患病率和特征。
我们使用 2009 年和 2010 年全国行为风险因素监测系统人群调查进行了一项患病率研究。从全美随机抽取的 25-99 岁个体的样本中收集数据。所有参与者均提供了 CVD 和癌症患病状况的信息。多变量回归分析确定了参与者特征与双重疾病负担患病率之间的关联。
在 442964 名研究参与者中，CVD 的总体患病率为 11%，癌症的患病率为 15%；有 3%的参与者报告称患有 CVD 和癌症两种疾病。65 岁以上人群 CVD+癌症的患病率增加了两倍（优势比[OR] 2.4，95%置信区间[CI] 2.3-2.5），≥75 岁人群的患病率又增加了一倍（OR 4.9，95% CI 4.6-5.1），男性（OR 1.6，95% CI 1.6-1.7）、多种族人群（OR 1.8，95% CI 1.5-2.0）和未完成高中学业的人群（OR 1.3，95% CI 1.2-1.4）的患病率更高。在患有 CVD 的人群中，有 25%的人还报告患有癌症，而所有癌症幸存者中有 19%的人患有 CVD。
随着年龄的增长，双重疾病负担的患病率增加；对于即将进入这个高风险年龄段的“婴儿潮一代”来说，这一点尤为重要。未来的研究应探讨 CVD 和癌症的潜在共同上游或下游机制，以及应对双重疾病负担的公共卫生策略。
