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- Title
Cardiovascular mortality among cancer survivors who developed breast cancer as a second primary malignancy.
- Authors
Wang, Chengshi; Hu, Kejia; Luo, Chuanxu; Deng, Lei; Fall, Katja; Tamimi, Rulla M.; Valdimarsdóttir, Unnur A.; Fang, Fang; Lu, Donghao
- Abstract
<bold>Background: </bold>To assess the risk of cardiovascular mortality among cancer survivors who developed breast cancer as a second malignancy (BCa-2) compared with patients with first primary breast cancer (BCa-1) and the general population.<bold>Methods: </bold>Using the Surveillance, Epidemiology, and End Results database, we conducted a population-based cohort study including 1,024,047 BCa-1 and 41,744 BCa-2 patients diagnosed from the age 30 between 1975 and 2016, and the corresponding US female population (994,415,911 person-years; 5,403,551 cardiovascular deaths). Compared with the general population and BCa-1 patients, we calculated incidence rate ratios (IRRs) of cardiovascular deaths among BCa-2 patients using Poisson regression. To adjust for unmeasured confounders, we performed a nested, case-crossover analysis among BCa-2 patients who died from cardiovascular disease.<bold>Results: </bold>Although BCa-2 patients had a mildly increased risk of cardiovascular mortality compared with the population (IRR 1.08) and BCa-1 patients (IRR 1.15), the association was pronounced among individuals aged 30-49 years (BCa-2 vs. population: IRR 6.61; BCa-2 vs. BCa-1: IRR 3.03). The risk elevation was greatest within the first month after diagnosis, compared with the population, but comparable with BCa-1 patients. The case-crossover analysis confirmed these results.<bold>Conclusion: </bold>Our findings suggest that patients with BCa-2 are at increased risk of cardiovascular mortality.
- Subjects
UNITED States; CARDIOVASCULAR disease related mortality; REPORTING of diseases; RESEARCH; RESEARCH methodology; CASE-control method; EVALUATION research; COMPARATIVE studies; SECONDARY primary cancer; RESEARCH funding; DEMOGRAPHY; CROSSOVER trials; BREAST tumors
- Publication
British Journal of Cancer, 2021, Vol 125, Issue 10, p1450
- ISSN
0007-0920
- Publication type
journal article
- DOI
10.1038/s41416-021-01549-w