Department of Medicine, University of Rochester Medical Center, Rochester, New York, United States.
Department of Medicine, National Committee for Quality Assurance, Washington, District of Columbia, United States.
J Am Geriatr Soc. 2022 Oct;70(10):2764-2774. doi: 10.1111/jgs.17921. Epub 2022 Jun 11.
This report summarizes the presentations, discussions, and recommendations of the most recent American Geriatrics Society and National Institute on Aging research conference, "Cancer and Cardiovascular Disease," on October 18-19, 2021. The purpose of this virtual meeting was to address the interface between cancer and heart disease, which are the two leading causes of death among older Americans. Age-related physiologic changes are implicated in the pathogenesis of both conditions. Emerging data suggest that cancer-related cardiovascular disease (CVD) involves disrupted cell signaling and cellular senescence. The risk factors for CVD are also risk factors for cancer and an increased likelihood of cancer death, and people who have both cancer and CVD do more poorly than those who have only cancer or only CVD. Issues addressed in this bench-to-bedside conference include mechanisms of cancer and CVD co-development in older adults, cardiotoxic effects of cancer therapy, and management of comorbid cancer and CVD. Presenters discussed approaches to ensure equitable access to clinical trials and health care for diverse populations of adults with CVD and cancer, mechanisms of cancer therapy cardiotoxicity, and management of comorbid CVD and cancer, including the role of patient values and preferences in treatment decisions. Workshop participants identified many research gaps and questions that could lead to an enhanced understanding of comorbid CVD and cancer and to better and more equitable management strategies.
本报告总结了美国老年医学会和国家老龄化研究所最近一次研究会议“癌症与心血管疾病”的演讲、讨论和建议。该虚拟会议于 2021 年 10 月 18 日至 19 日举行，旨在探讨癌症和心脏病之间的关系，这两者是导致美国老年人死亡的两大主要原因。与年龄相关的生理变化与这两种疾病的发病机制有关。新出现的数据表明，与癌症相关的心血管疾病（CVD）涉及细胞信号中断和细胞衰老。CVD 的风险因素也是癌症的风险因素，并且癌症死亡的可能性增加，同时患有癌症和 CVD 的人比仅患有癌症或仅患有 CVD 的人预后更差。本次从基础到临床的会议中讨论的问题包括老年人群中癌症和 CVD 共同发展的机制、癌症治疗的心脏毒性作用以及合并癌症和 CVD 的管理。演讲者讨论了确保患有 CVD 和癌症的不同人群公平获得临床试验和医疗保健的方法、癌症治疗心脏毒性的机制以及合并 CVD 和癌症的管理，包括患者价值观和治疗决策中的偏好的作用。研讨会参与者确定了许多研究空白和问题，这些问题可能会导致对合并 CVD 和癌症的更好和更公平的管理策略的理解。
