Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.
Curr Probl Cancer. 2021 Feb;45(1):100615. doi: 10.1016/j.currproblcancer.2020.100615. Epub 2020 Jun 24.
In lung cancer survivors, cardiovascular diseases (CVDs) are the leading cause of noncancer deaths. Nonetheless, there is lack of information on management of dyslipidemia, a major risk factor for future CVD events, in lung cancer survivors. This study aimed to assess dyslipidemia management and prevalence of statin eligibility in lung cancer survivors.
From the Korean National Health Insurance Service database, we selected 7349 lung cancer survivors who received surgery for lung cancer from 2007 to 2014. We used descriptive statistics for analyses of dyslipidemia management status on the basis of the National Cholesterol Education Program Adult Treatment Panel III guidelines. We also identified those who met the criteria for treatment on the basis of CVD risk according to the 2018 American College of Cardiology and American Heart Association (ACC/AHA) guidelines.
The overall awareness and treatment rates for lung cancer survivors with dyslipidemia were 31.8% and 29.7%, respectively. The overall control rate for those receiving treatment was 88.7%, but was lowest in the highest risk group (78.1%). Furthermore, undertreatment of dyslipidemia was more prominent in young, male lung cancer survivors and those diagnosed with lung cancer within 3 years. Among those not receiving treatment for dyslipidemia, 61.7% were indicated for statin according to the ACC/AHA guidelines.
Over half of lung cancer survivors were not receiving treatment, although they were eligible for statin under current guidelines. To reduce noncancer mortality, statin use and adequate management of CVD risk factors should be encouraged in lung cancer survivors.
在肺癌幸存者中，心血管疾病（CVDs）是导致非癌症死亡的主要原因。尽管如此，对于肺癌幸存者中血脂异常的管理，即未来 CVD 事件的主要危险因素，缺乏相关信息。本研究旨在评估肺癌幸存者的血脂异常管理情况和他汀类药物适用的患病率。
我们从韩国国家健康保险服务数据库中选择了 7349 名在 2007 年至 2014 年间因肺癌接受手术治疗的肺癌幸存者。我们使用描述性统计方法，根据国家胆固醇教育计划成人治疗小组 III 指南，分析血脂异常管理状况。我们还根据 2018 年美国心脏病学会/美国心脏协会（ACC/AHA）指南中 CVD 风险标准，确定符合治疗标准的患者。
肺癌幸存者血脂异常的总体知晓率和治疗率分别为 31.8%和 29.7%。接受治疗者的总体控制率为 88.7%，但在风险最高的组中最低（78.1%）。此外，年轻、男性肺癌幸存者和确诊肺癌后 3 年内的患者血脂异常治疗不足的情况更为突出。在未接受血脂异常治疗的患者中，根据 ACC/AHA 指南，有 61.7%的患者需要使用他汀类药物。
尽管当前指南建议使用他汀类药物，但超过一半的肺癌幸存者未接受治疗。为了降低非癌症死亡率，应鼓励肺癌幸存者使用他汀类药物并充分管理 CVD 风险因素。
