Sex and Racial/Ethnic Disparities in Cardiovascular Disease Mortality Risk Among United States Cancer Patients

OBJECTIVES: People diagnosed with cancer have an elevated risk of cardiovascular disease (CVD) mortality compared with the general population. However, little research has focused on sex and racial/ethnic disparities in cardiovascular mortality for this population. This study aimed to examine whether the risks and patterns in cardiovascular mortality vary across sex and race/ethnicity among individuals with cancer.

METHODS: The Surveillance, Epidemiology, and End Results Program 18 registries database was used to obtain data on individuals diagnosed with a first primary malignant tumor in 2000-2018. Standardized mortality ratios (SMRs) were calculated using coded cause of death from CVDs, including heart disease, hypertension, cerebrovascular disease, atherosclerosis, aortic aneurysm and dissection, and other diseases of arteries, arterioles, and capillaries.

RESULTS: A total of 5,605,017 US adults with cancer diagnoses were included. Most were male (51.0%), non-Hispanic White (72.0%), and older than 65 years (49.1%). Among them, 329,585 patients (5.9%) died from CVDs (SMR: 1.08; 95% CI: 1.07-1.08). Females had a significantly higher CVD mortality risk than males (SMR: 1.12; 95% CI: 1.11-1.13 vs SMR: 1.05; 95% CI: 1.04-1.05). Hispanics exhibited a reduced risk compared with their counterparts in the general population (SMR: 0.96; 95% CI: 0.95-0.98), while non-Hispanics showed an increased risk of mortality attributable to CVDs (SMR: 1.09; 95% CI: 1.08-1.09). Within non-Hispanic race groups, the SMRs were the highest among American Indians/Alaska Natives (AIAN; SMR: 1.98; 95% CI: 1.86-2.11), followed by Asian or Pacific Islanders (SMR: 1.29; 95% CI: 1.27-1.31) and Blacks (SMR: 1.21; 95% CI: 1.20-1.22). The disparity by sex remained consistent across race/ethnicity groups except AIAN due to the limited number of CVD deaths.

CONCLUSIONS: The study findings shed light on disparities in CVD mortality risk among cancer patients by sex and race/ethnicity. Further research and effort to monitor cardiovascular health, addressing these disparities in cancer patients, could prove advantageous.