Gao Shuaijie, Zhu Hao, Chang Xinyu, Cao Xiting, Wang Zhenwei, Chu Xiaoxuan, Zhang Lu, Wang Xinhua, Lu Jie
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University.
Oncology Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Eur J Cancer Prev. 2025 Jan 1;34(1):11-23. doi: 10.1097/CEJ.0000000000000921. Epub 2024 Aug 26.
Previous studies have focused on the risk of cardiovascular disease (CVD)-specific death in hematological cancers and in some single anatomical tumor sites, there remains a paucity of data on systematic analyses in solid tumors.
The objective of this study is to evaluate the distribution, risk, and trends of CVD-specific death in patients with solid tumors.
A total of 2 679 293 patients with solid tumors diagnosed between 1975 and 2019 were screened from the Surveillance, Epidemiology and End Results (SEER) program across 15 anatomical sites. Standardized mortality ratios (SMRs) and absolute excess risks (AERs) were used to describe the intensity of CVD-specific death, competing risk regression models were used to assess the risk of CVD-specific death, and restricted cubic spline analyses were employed to investigate the potential linear or nonlinear relationship between age and CVD death.
CVD-specific death in patients with solid tumors accounted for 48.95% of non-cancer deaths. Compared with the general population, patients with solid tumors had higher SMR and AER of CVD death (SMR: 1.15; AER: 21.12), heart disease-related death (SMR: 1.13; AER: 13.96), and cerebrovascular disease-related death (SMR: 1.20; AER: 4.85). Additionally, the SMR exhibited a decreasing trend with increasing time to diagnosis. Furthermore, a nonlinear relationship was observed between age and CVD-specific death in patients with solid tumors of different systems.
CVD-specific death accounted for a large proportion of the cause of non-cancer deaths. Patients with solid tumors exhibit an elevated risk of CVD-specific death. Screening for CVD death and optimizing risk management in patients with solid tumors throughout anticancer treatment may be beneficial in preventing CVD death.
既往研究主要关注血液系统癌症中心血管疾病（CVD）特异性死亡风险，而在一些单一解剖学肿瘤部位，关于实体瘤系统分析的数据仍然匮乏。
本研究旨在评估实体瘤患者中CVD特异性死亡的分布、风险及趋势。
从监测、流行病学和最终结果（SEER）计划中筛选出1975年至2019年间诊断的共2679293例实体瘤患者，涉及15个解剖部位。采用标准化死亡比（SMR）和绝对超额风险（AER）来描述CVD特异性死亡的强度，使用竞争风险回归模型评估CVD特异性死亡风险，并采用受限立方样条分析研究年龄与CVD死亡之间潜在的线性或非线性关系。
实体瘤患者的CVD特异性死亡占非癌症死亡的48.95%。与普通人群相比，实体瘤患者的CVD死亡SMR和AER更高（SMR：1.15；AER：21.12），心脏病相关死亡（SMR：1.13；AER：13.96），以及脑血管疾病相关死亡（SMR：1.20；AER：4.85）。此外，SMR随诊断时间的增加呈下降趋势。此外，在不同系统实体瘤患者中，年龄与CVD特异性死亡之间存在非线性关系。
CVD特异性死亡在非癌症死亡原因中占很大比例。实体瘤患者的CVD特异性死亡风险升高。在整个抗癌治疗过程中对实体瘤患者进行CVD死亡筛查并优化风险管理，可能有助于预防CVD死亡。
