The individuals at highest risk of being
diagnosed with one of these cardiovascular problems, the study found, were
those who were African-American,
didn’t have health insurance or had
public health insurance, or lived in low
The study, led by Theresa Keegan,
a cancer epidemiologist at the UC
Davis Comprehensive Cancer Center
in California, used data collected by
the California Cancer Registry and
California hospitals to look at cardio-
vascular disease diagnoses among 79,167
adolescents and young adults ages 15 to
39 who were diagnosed with one of 14
common cancers between 1996 and 2012.
The study found that 2,249 patients,
or 2. 8 percent, developed cardiovascular disease. Within this group, 218
were African-American, 722 had no
health insurance or had public health
insurance, and 928 lived in the two
lowest-income neighborhoods. African-Americans had a 55 percent higher risk
than non-Hispanic whites; those who
didn’t have health insurance or had public
health insurance had a 78 percent higher
risk than those with private health insurance; and the individuals in the lowest-income neighborhoods had a 60 to 66
percent higher risk than those living in
the wealthiest neighborhood.
The study controlled for other factors
that might affect cardiovascular disease
risk, like age at cancer diagnosis, gender,
cancer type and treatment type (surgery,
chemotherapy, radiation or stem
Keegan says her study is the first to
look at the risk of heart disease and stroke
in adolescent and young adult survivors
who did not have health insurance or had
public health insurance. Previous studies
have found that overall survival among
young cancer survivors differs due to
factors such as health insurance status,
socioeconomic status and race, she says.
Tiffany L. Carson, an associate scientist at the Comprehensive Cancer
Center at the University of Alabama at
Birmingham, says she doesn’t find the
study’s results surprising, given how
race and income are associated with
health outcomes. Even so, she does think
young survivors can use the information
to their advantage.
“Just because you’re part of this group
doesn’t mean your fate is predetermined,”
Carson says. “But if you align with one of
these at-risk groups, you have to be more
intentional about engaging in healthier
behaviors,” like maintaining a healthy diet,
exercising and not smoking.
It’s possible that not having health insurance or having public health insurance
may have increased the risk of cardiovascular disease because it limited access to
preventive care, Keegan says. Living in a
low-income neighborhood may also mean
travel is required to see a doctor, which
could make follow-up care difficult. It could
also mean a lack of safe places to exercise,
which could increase risk for obesity. But
Keegan can’t say for sure. The data she
and her colleagues analyzed didn’t provide
lifestyle information, such as survivors’
weight, exercise habits or smoking status.
Keegan says developing programs to
identify and treat diabetes, hypertension
and other risk factors for cardiovascular
disease among young adult cancer survivors could potentially help reduce rates of
coronary artery disease, heart failure and
stroke. “It is also critical to address barriers to obtaining follow-up care,” she says.
—DARA CHAD WICK
New Drug Combo for Women With Rare Type of Uterine Cancer
A phase II trial of 61 women with uterine serous carcinoma found that adding Herceptin
(trastuzumab) to chemotherapy kept tumors in check three to eight months longer than
chemotherapy alone. The findings could lead to new treatment guidelines for this type
of uterine cancer. Although only about 10 percent of all uterine cancers are serous, this
subtype is expected to account for more than a third of the estimated 11,350 uterine cancer
deaths that will occur this year.
LEARN MORE IN THE MARCH 27, 2018, JOURNAL OF CLINICAL ONCOLOG Y.
Sigmoidoscopy Reduces Colon Cancer in Men,
but Not in Women
A clinical trial in Norway that randomized
more than 98,000 women and men ages
50 to 64 to a one-time sigmoidoscopy
screening or no screening found that
sigmoidoscopy screening was more
effective in men than in women. Over
17 years, among those in the screening
group, colon cancer incidence rates in
men were reduced by 34 percent and
death rates were reduced by 37 percent.
For women, screening had no significant
benefits. It is not clear why the screening
test was not effective in women.
LEARN MORE IN THE APRIL 24, 2018,
ANNALS OF INTERNAL MEDICINE.
Some Young Survivors Have
Higher Heart Disease Risk
FINDINGS MAY HELP IMPROVE
Adolescents and young adults who have been treated for cancer have an increased risk of developing coronary artery disease, experiencing heart failure or having a stroke.
But a study published online Feb. 9, 2018, in the Journal of Cancer
Survivorship shows that not all young survivors carry the same risk.