Prevalence of cardiovascular disease (CVD) risk factors and preventive care among U.S. cancer survivors.

Authors

null

Kevin A. Pearlstein

The University of North Carolina at Chapel Hill, Chapel Hill, NC

Kevin A. Pearlstein , Laura H. Hendrix , Ronald C. Chen

Organizations

The University of North Carolina at Chapel Hill, Chapel Hill, NC

Research Funding

No funding sources reported

Background: CVD is a major cause of mortality in cancer survivors. Prior claims-based studies suggested underutilization of preventive care in cancer survivors, but most CVD preventive care items are not available in claims data. We directly examined the prevalence of CVD risk factors and receipt of care in survivors compared to the non-cancer general population (control) using the National Health Interview Survey. Methods: 32,934 cancer survivors interviewed between 1999 and 2011 were matched to 65819 controls based on age, race, and history of CVD events (angina, myocardial infarction, stroke). Statistical analysis accounted for population sampling weight. Results: CVD risk factors were prevalent among cancer survivors (Table), and 33% continued to smoke. Primary care visits were reported more often among survivors compared to controls (83% vs 74%, p<0.001). A high proportion of survivors and controls received monitoring for diagnosed CVD risk factors, while rates of interventions to modify the risk factors were more modest. On multivariable logistic regression models, having a general doctor visit was associated with increased monitoring for all CVD risk factors examined (hypertension, hyperlipidemia, diabetes, obesity, smoking),but there was no significant difference between cancer vs control. Conclusions: Cancer survivors in the US receive comparable monitoring and interventions for CVD risk factors compared to non-cancer individuals. Survivorship care involving a general doctor was associated with improved monitoring of CVD risk factors.

Prevalence Monitoring in individuals
with risk factor
Intervention in individuals
with risk factor
Risk factor Cancer survivor Definition Cancer Control P Definition Cancer Control P
Hypertension 49% Blood pressure check
in past year
96% 93% <.01 Instructed to modify lifestyle 75% 75% .79
Prescribed medication 89% 88% .42
Taking medication 91% 92% .44
Diabetes 14% Glucose check
in past 3 years
85% 86% .29 Taking oral hypoglycemic 48% 49% .14
Taking insulin 19% 20% .47
Hyperlipidemia 41% Cholesterol check in past year 91% 89% .05 - - - -
Obesity 30% - - - - Exercise in past month 44% 41% <.01
Smoking 33% - - - - Smoking cessation attempt
in past year
45% 41% <.01

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Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Patient and Survivor Care

Track

Patient and Survivor Care

Sub Track

Survivorship

Citation

J Clin Oncol 31, 2013 (suppl; abstr 9592)

DOI

10.1200/jco.2013.31.15_suppl.9592

Abstract #

9592

Poster Bd #

34D

Abstract Disclosures

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