Líf - og heilbrigðisvísindaráðstefna Háskóla Íslands 2023

Cardiovascular disease following cancer diagnosis in the Icelandic population: a population-based cohort study

Valentin Walker, Thor Aspelund, Jóhanna Jakobsdóttir, Unnur Valdimarsdóttir

Introduction: A diagnosis of cancer is a highly stressful experience which, in addition to harmful effects of the cancer itself and its treatment, can cause adverse health outcomes in patients. The purpose of this study is to investigate the association between a cancer diagnosis and cardiovascular events in the Icelandic population.
Methods and data: Patients (≥18 years) diagnosed with cancer between 1999 and 2019 were identified in the National Cancer Register. By record linkage to the Genealogy database (Íslendingabók), these patients were matched (sex/age) with cancer-free individuals (1:4-ratio) and their full siblings. We used Cox proportional-hazard models to estimate Hazard Ratios (HRs) and 95% Confidence Intervals (CI) as a measure of the association between cancer diagnosis and the time to cardiovascular events, adjusting for additional comorbidities.
Results: During 1999-2019, 15,414 patients (median age: 65) were diagnosed with cancer and were free of prior cardiovascular disease, of which 4,749 (30.8%) then experienced a cardiovascular event. Compared to cancer-free individuals, patients diagnosed with cancer were at elevated relative risk of cardiovascular disease during the entire follow-up (HR: 1.6; 95%CI: 1.5-1.7), especially during the first year after diagnosis (HR: 2.8; 95%CI: 2.6-3.0). During the first year, the relative increase was particularly prominent for lung cancer (HR: 6.3; 95%CI: 4.3-9.4) and other cancers with poor prognosis (HR: 7.0; 95%CI: 3.8-12.9). Results from the sibling analysis are pending (presented in May).
Conclusions: These preliminary findings suggest that patients diagnosed with cancer are at increased risk of subsequent cardiovascular disease, especially the first year after diagnosis.


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