Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
Huntsman Cancer Institute, Salt Lake City, UT, USA.
Cancer Med. 2021 Jun;10(12):4117-4126. doi: 10.1002/cam4.3934. Epub 2021 May 12.
Young cancer survivors may be at increased risk of early-onset chronic health conditions. The aim of this population-based study is to estimate cardiovascular disease (CVD) risk among younger versus older B-cell non-Hodgkin's lymphoma (B-NHL) survivors compared with their respective general population cohorts.
B-NHL survivors diagnosed from 1997 to 2015 in the Utah Cancer Registry were matched with up to five cancer-free individuals on birth year, sex, and birth state, using the statewide Utah Population Database. Electronic medical records and statewide health care facility data were used to identify disease outcomes ≥5 years after cancer diagnosis. Cox Proportional Hazards models were used to estimate hazard ratios for B-NHL survivors diagnosed at <65 years and ≥65 years old.
Younger B-NHL survivors had higher relative risks than older cancer survivors of chronic rheumatic disease of the heart valves (HR = 4.14, 99% CI = 2.17-7.89; P value = 0.004); peri-, endo-, and myocarditis (HR = 2.43, 99% CI = 1.38-4.28; P value = 0.016); diseases of the arteries (HR = 1.63, 99% CI = 1.21-2.21; P value = 0.044); and hypotension (HR = 2.44, 99% CI = 1.58-3.75; P value = 0.048). B-NHL survivors of both age groups had elevated relative risks of heart disease overall and congestive heart failure.
Younger B-NHL survivors had higher risks than older B-NHL survivors of specific cardiovascular diseases compared to their respective general population cohorts.
年轻的癌症幸存者可能面临更高的早发性慢性健康问题风险。本基于人群的研究旨在估计年轻与年长 B 细胞非霍奇金淋巴瘤 (B-NHL) 幸存者相比,其心血管疾病 (CVD) 风险。
在犹他州癌症登记处诊断出的 B-NHL 幸存者于 1997 年至 2015 年期间进行诊断,并通过全州犹他州人口数据库,按出生年份、性别和出生州与最多 5 名无癌症个体进行匹配。使用电子病历和全州医疗设施数据来识别癌症诊断后≥5 年的疾病结局。使用 Cox 比例风险模型来估计<65 岁和≥65 岁诊断的 B-NHL 幸存者的风险比。
与年长的癌症幸存者相比,年轻的 B-NHL 幸存者患有慢性风湿性心脏病瓣膜疾病的相对风险更高 (HR = 4.14, 99%CI = 2.17-7.89; P 值 = 0.004); 心外膜炎、心肌炎和心内膜炎 (HR = 2.43, 99%CI = 1.38-4.28; P 值 = 0.016); 动脉疾病 (HR = 1.63, 99%CI = 1.21-2.21; P 值 = 0.044); 和低血压 (HR = 2.44, 99%CI = 1.58-3.75; P 值 = 0.048)。两个年龄组的 B-NHL 幸存者都有更高的心脏病和充血性心力衰竭的相对风险。
与各自的普通人群队列相比,年轻的 B-NHL 幸存者比年长的 B-NHL 幸存者更易患某些心血管疾病。