University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Department of Epidemiology, Utrecht, 3584, CX, The Netherlands.
National University of Singapore, Saw Swee Hock School of Public Health, Singapore, 117549, Singapore.
Sci Rep. 2017 May 2;7(1):1365. doi: 10.1038/s41598-017-01540-7.
Breast cancer incidence and survival is high in Southeast Asia. As such, many women diagnosed with breast cancer are at risk of dying of other causes. Given the increased risk of cardiotoxicity induced by breast cancer treatments, it is important to identify patients at high risk of cardiovascular disease (CVD) mortality. The aim of this study was to investigate if this risk varies by age and ethnicity. Patient details were obtained from 5,868 Chinese, Malay, and Indian women diagnosed with in situ or non-metastasized invasive breast cancer at the National University Hospital of Singapore and KK Women's and Children's Hospital in Singapore. Death causes were obtained from the National Registry of Births and Deaths. Flexible parametric survival models estimated CVD mortality rates and hazard ratios. During a median follow-up of six years, 1,010 deaths occurred of which 6.8% were due to CVD. CVD mortality rates of older women peaked within the first year following diagnosis and increased over time since diagnosis. Indian had more than double the risk of CVD mortality than Chinese, independent of age at diagnosis and stage. Taking ethnicity and age into account may promote CVD risk stratification and management in (Southeast Asian) women with breast cancer.
乳腺癌在东南亚的发病率和存活率都很高。因此，许多被诊断出患有乳腺癌的女性都有死于其他原因的风险。鉴于乳腺癌治疗引起的心脏毒性风险增加，识别心血管疾病（CVD）死亡率高的患者非常重要。本研究旨在探讨这种风险是否因年龄和种族而异。患者详细信息来自新加坡国立大学医院和新加坡 KK 妇女儿童医院诊断为原位或非转移性浸润性乳腺癌的 5868 名中国、马来和印度女性。死亡原因从国家出生和死亡登记处获得。灵活的参数生存模型估计了 CVD 死亡率和危险比。在中位数为六年的随访期间，有 1010 人死亡，其中 6.8%死于 CVD。老年女性的 CVD 死亡率在诊断后第一年达到峰值，并随着诊断后时间的推移而增加。印度人的 CVD 死亡率是中国人的两倍多，独立于诊断时的年龄和分期。考虑种族和年龄因素可能会促进（东南亚）乳腺癌女性的 CVD 风险分层和管理。
