Risk of cardiac death among cancer survivors in the United States; a SEER database analysis

Population-based data on the risk of cardiac death among cancer survivors are needed. This scenario was evaluated in cancer survivors (>5 years) registered within the Surveillance, Epidemiology and End Results (SEER) database.

The SEER database was queried using the SEER*Stat program to determine the frequency of cardiac death compared to other causes of death and to determine heart disease-specific and cancer-specific survival rates in each of the 10 most common cancers in men and women in the SEER database (including colorectal, lung, breast, prostate, uterine corpus, urinary bladder, kidney, thyroid cancers, cutaneous melanoma and non-Hodgkin lymphoma). Associations were ascertained with Chi-squared tests and multivariate analyses were conducted through Cox-proportional hazard models.

For the frequency and survival sessions 2513716 patients (diagnosed between 1973 and 2008) were assessed, while for the case listing session 2146496 patients (diagnosed between 1988 and 2008) were assessed. For survivors of all 10 cancers combined, the 10-year cancer specific survival rate was 91.4% while 10-year heart disease-specific survival rate was 94.6%. For cancer-specific survival rates, the highest rates were related to thyroid cancer survivors while the lowest rates were related to lung cancer survivors. For heart disease-specific survival rates, the highest rates were related to thyroid cancer survivors while the lowest rates were related to both lung cancer survivors and urinary bladder cancer survivors. The following factors were associated with a higher likelihood of cardiac death: male gender, old age at diagnosis, black race and local treatment with radiotherapy rather than surgery (P<0.0001 for all parameters).

Among cancer survivors (>5 years), cardiac death is a significant cause of death and there is a wide variability among different cancers in the relative importance of cardiac death vs. cancer-related death.

Expert review of anticancer therapy. 2017 Jun 16 [Epub ahead of print]

Omar Abdel-Rahman

a Clinical Oncology Department, Faculty of Medicine , Ain Shams University , Cairo , Egypt .