Racial and Ethnic Disparities in All-Cause and Cardiovascular Mortality Among Cancer Patients in the U.S

Authors

Cenjing Zhu, Department of Chronic Disease Epidemiology, Yale University, New Haven, Connecticut, USA.
Tiantian Shi, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Changchuan Jiang, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.Follow
Baoqiong Liu, Division of Cardiology, Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Lauren A. Baldassarre, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Stuart Zarich, Division of Cardiovascular Medicine, Bridgeport Hospital, Yale New Haven Health System, Bridgeport, Connecticut, USA.

Document Type

Article

Publication Title

JACC. CardioOncology

Abstract

BACKGROUND: With improved cancer survival, death from noncancer etiologies, especially cardiovascular disease (CVD) mortality, has come more into focus. Little is known about the racial and ethnic disparities in all-cause and CVD mortality among U.S. cancer patients. OBJECTIVES: This study sought to investigate racial and ethnic disparities in all-cause and CVD mortality among adults with cancer in the United States. METHODS: Using the Surveillance, Epidemiology, and End Results (SEER) database from years 2000 to 2018, all-cause and CVD mortality among patients ≥18 years of age at the time of initial malignancy diagnosis were compared by race and ethnicity groups. The 10 most prevalent cancers were included. Cox regression models were used to estimate adjusted HRs for all-cause and CVD mortality using Fine and Gray's method for competing risks, as applicable. RESULTS: Among a total of 3,674,511 participants included in our study, 1,644,067 (44.7%) died, with 231,386 (6.3%) deaths as a result of CVD. After adjusting for sociodemographic and clinical characteristics, non-Hispanic (NH) Black individuals had both higher all-cause (HR: 1.13; 95% CI: 1.13-1.14) and CVD (HR: 1.25; 95% CI: 1.24-1.27) mortality, whereas Hispanic and NH Asian/Pacific Islander had lower mortality than NH White patients. Racial and ethnic disparities were more prominent among patients 18 to 54 years of age and those with localized cancer. CONCLUSIONS: Significant racial and ethnic differences exist in both all-cause and CVD mortality among U.S. cancer patients. Our findings underscore the vital roles of accessible cardiovascular interventions and strategies to identify high-risk cancer populations who may benefit most from early and long-term survivorship care.

First Page

55

Last Page

66

DOI

10.1016/j.jaccao.2022.10.013

Publication Date

2-1-2023

Recommended Citation

Zhu, Cenjing; Shi, Tiantian; Jiang, Changchuan; Liu, Baoqiong; Baldassarre, Lauren A.; and Zarich, Stuart, "Racial and Ethnic Disparities in All-Cause and Cardiovascular Mortality Among Cancer Patients in the U.S" (2023). Cardiology. 3.
https://scholar.bridgeporthospital.org/cardiology/3

Identifier

36875907 (pubmed); PMC9982284 (pmc); 10.1016/j.jaccao.2022.10.013 (doi); S2666-0873(23)00005-4 (pii)