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社区环境下常规癌症随访中心血管健康评估:幸存者风险意识和观点。

Cardiovascular health assessment in routine cancer follow-up in community settings: survivor risk awareness and perspectives.

机构信息

Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC, 27157, USA.

Department of Biostatistics and Data Science, Wake Forest University School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC, 27157, USA.

出版信息

BMC Cancer. 2024 Jan 31;24(1):158. doi: 10.1186/s12885-024-11912-8.


DOI:10.1186/s12885-024-11912-8
PMID:38297229
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10829276/
Abstract

BACKGROUND: Guidelines recommend cardiovascular risk assessment and counseling for cancer survivors. For effective implementation, it is critical to understand survivor cardiovascular health (CVH) profiles and perspectives in community settings. We aimed to (1) Assess survivor CVH profiles, (2) compare self-reported and EHR-based categorization of CVH factors, and (3) describe perceptions regarding addressing CVH during oncology encounters. METHODS: This cross-sectional analysis utilized data from an ongoing NCI Community Oncology Research Program trial of an EHR heart health tool for cancer survivors (WF-1804CD). Survivors presenting for routine care after potentially curative treatment recruited from 8 oncology practices completed a pre-visit survey, including American Heart Association Simple 7 CVH factors (classified as ideal, intermediate, or poor). Medical record abstraction ascertained CVD risk factors and cancer characteristics. Likert-type questions assessed desired discussion during oncology care. RESULTS: Of 502 enrolled survivors (95.6% female; mean time since diagnosis = 4.2 years), most had breast cancer (79.7%). Many survivors had common cardiovascular comorbidities, including high cholesterol (48.3%), hypertension or high BP (47.8%) obesity (33.1%), and diabetes (20.5%); 30.5% of survivors received high cardiotoxicity potential cancer treatment. Less than half had ideal/non-missing levels for physical activity (48.0%), BMI (18.9%), cholesterol (17.9%), blood pressure (14.1%), healthy diet (11.0%), and glucose/ HbA1c (6.0%). While > 50% of survivors had concordant EHR-self-report categorization for smoking, BMI, and blood pressure; cholesterol, glucose, and A1C were unknown by survivors and/or missing in the EHR for most. Most survivors agreed oncology providers should talk about heart health (78.9%). CONCLUSIONS: Tools to promote CVH discussion can fill gaps in CVH knowledge and are likely to be well-received by survivors in community settings. TRIAL REGISTRATION: NCT03935282, Registered 10/01/2020.

摘要

背景:指南建议对癌症幸存者进行心血管风险评估和咨询。为了有效实施,了解社区环境中幸存者的心血管健康(CVH)状况和观点至关重要。我们旨在:(1)评估幸存者的 CVH 状况,(2)比较自我报告和基于电子健康记录(EHR)的 CVH 因素分类,以及(3)描述在肿瘤学就诊期间解决 CVH 的看法。 方法:本横断面分析利用了正在进行的 NCI 社区肿瘤学研究计划中一项针对癌症幸存者的 EHR 心脏健康工具(WF-1804CD)的研究数据。从 8 个肿瘤学诊所招募了接受潜在治愈性治疗后进行常规护理的幸存者,他们完成了就诊前调查,包括美国心脏协会简单 7 项 CVH 因素(分类为理想、中等或较差)。病历摘录确定了 CVD 风险因素和癌症特征。李克特式问题评估了在肿瘤学治疗中希望进行的讨论。 结果:在 502 名入组的幸存者中(95.6%为女性;诊断后平均时间为 4.2 年),大多数人患有乳腺癌(79.7%)。许多幸存者患有常见的心血管合并症,包括高胆固醇(48.3%)、高血压或高血压(47.8%)、肥胖症(33.1%)和糖尿病(20.5%);30.5%的幸存者接受了高心脏毒性潜在的癌症治疗。仅有不到一半的幸存者具有理想/非缺失的体力活动(48.0%)、BMI(18.9%)、胆固醇(17.9%)、血压(14.1%)、健康饮食(11.0%)和血糖/糖化血红蛋白(6.0%)。虽然超过 50%的幸存者的 EHR 自我报告分类在吸烟、BMI 和血压方面是一致的;但对于胆固醇、葡萄糖和 A1C,幸存者并不了解或 EHR 中多数情况下缺失。大多数幸存者同意肿瘤学提供者应该讨论心脏健康(78.9%)。 结论:促进 CVH 讨论的工具可以填补 CVH 知识的空白,并且很可能在社区环境中受到幸存者的欢迎。 试验注册:NCT03935282,2020 年 10 月 1 日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ff/10829276/40c1b21082dd/12885_2024_11912_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ff/10829276/b2e292550e01/12885_2024_11912_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ff/10829276/a2bb9326505d/12885_2024_11912_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ff/10829276/40c1b21082dd/12885_2024_11912_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ff/10829276/b2e292550e01/12885_2024_11912_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ff/10829276/a2bb9326505d/12885_2024_11912_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ff/10829276/40c1b21082dd/12885_2024_11912_Fig3_HTML.jpg

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[6]
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[7]
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本文引用的文献

[1]
Cardiovascular Disease Risk Among Cancer Survivors: The Atherosclerosis Risk In Communities (ARIC) Study.

J Am Coll Cardiol. 2022-7-5

[2]
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Circulation. 2022-9-13

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Circulation. 2022-8-2

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Gynecol Oncol. 2022-6

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