Choi Hea Lim, Kang Danbee, Kim Hyunsoo, Cho Juhee, Jeon Keun Hye, Jung Wonyoung, Lee Yoo-Young, Jeong Su-Min, Shin Dong Wook
Department of Family Medicine/Executive Healthcare Clinic, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea.
J Gynecol Oncol. 2025 Sep;36(5):e75. doi: 10.3802/jgo.2025.36.e75. Epub 2025 Mar 4.
To investigate the incidence and risk factors of cardiovascular disease (CVD) in adolescent and young adult survivors of cervical cancer.
This retrospective cohort study used data from the Korean National Health Insurance Service. Adolescent and young adult (AYA) cervical cancer survivors (n=7,803) were matched with non-cancer controls (n=23,327) using 1:3 propensity score matching, and hazard ratios (HRs) for CVD were determined using Cox regression models. Multivariable Cox regressions were used to assess CVD incidence according to cancer treatment and identify risk factors.
A total of 7,803 AYA survivors with cervical cancer were analyzed in this study during a median 8.9 years of follow-up. They developed any CVD with an adjusted HR of 1.47 (95% confidence interval [CI]=1.33-1.62) compared with the non-cancer controls. Those who underwent concurrent chemoradiotherapy had markedly elevated risks of heart failure (subHR=2.66; 95% CI=1.24-5.72), ischemic heart disease (subHR=1.78, 95% CI=1.11-2.86), deep vein thrombosis (subHR=15.32; 95% CI=9.16-25.63), and pulmonary embolism (subHR=14.99; 95% CI=6.31-35.62). Diabetes, hypertension and chemoradiation therapy were identified as potential risk factors that increase the risk of CVD by 1.55-fold, 1.62-fold and 2.64-fold, respectively.
These findings indicate a need to pay increased attention to cardiovascular health management in adolescent and young adult cervical cancer survivors, particularly those treated with chemoradiotherapy.
调查宫颈癌青少年及年轻成年幸存者心血管疾病（CVD）的发病率及危险因素。
这项回顾性队列研究使用了韩国国民健康保险服务的数据。采用1:3倾向评分匹配法将青少年及年轻成年（AYA）宫颈癌幸存者（n = 7803）与非癌症对照者（n = 23327）进行匹配，并使用Cox回归模型确定CVD的风险比（HRs）。采用多变量Cox回归分析根据癌症治疗情况评估CVD发病率并确定危险因素。
本研究共分析了7803例AYA宫颈癌幸存者，中位随访时间为8.9年。与非癌症对照者相比，他们发生任何CVD的校正HR为1.47（95%置信区间[CI]=1.33 - 1.62）。接受同步放化疗的患者发生心力衰竭（亚HR = 2.66；95% CI = 1.24 - 5.72）、缺血性心脏病（亚HR = 1.78，95% CI = 1.11 - 2.86）、深静脉血栓形成（亚HR = 15.32；95% CI = 9.16 - 25.63）和肺栓塞（亚HR = 14.99；95% CI = 6.31 - 35.62）的风险显著升高。糖尿病、高血压和放化疗被确定为分别使CVD风险增加1.55倍、1.62倍和2.64倍的潜在危险因素。
这些发现表明，需要更加关注宫颈癌青少年及年轻成年幸存者的心血管健康管理，尤其是接受放化疗的患者。
