Monitoring risk factors of cardiovascular disease in cancer survivors

Abstract

There exist published literature for cardiovascular disease (CVD) risk monitoring in cancer survivors but the extent of monitoring in clinical oncology practice is unknown. We performed an interactive survey at a Royal College of Physicians conference (11 November 2016) attended by practitioners with an interest in late effects of cancer treatment and supplemented the survey with an audit among 32 lung cancer survivors treated at St Peter's NHS Hospital in 2012-2016. Among the practitioners, 40% reported CVD risk monitoring performed at least annually, which is compatible with European Group for Blood and Marrow Transplantation Guidelines, but 31% indicated that monitoring was never performed. In contrast, 77% felt that at least an annual assessment was required (p<0.001). Corroborating these data, among the lung cancer survivors, 31% and 16% had lipids or glucose/HbA1C measured annually, and 28% and 31% had never had these tests performed since their cancer treatment. Alerting healthcare providers to review protocols may help reduce CVD after cancer treatments.

Keywords: CVD prevention; cardiometabolic risk; health promotion; late effects.

Fig 1.

Frequency of monitoring risk factors for cardiovascular disease (CVD) in cancer survivors. CVD risk factors include weight, waist circumference, blood pressure, lipids and glucose. Differences between categories: χ²=112 (p<0.001). Please note, the composite variables in this figure contain waist circumference as well as other factors; this results in a ‘dilutional effect’ and, therefore, the proportions of responders for each category of frequency of monitoring would differ between this figure and the results in Table 1. Please refer to the methods section for details on derivation of composite variables.