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. 2019 Aug;24(8):983-994.
doi: 10.1007/s10147-019-01426-w. Epub 2019 Mar 22.

Future projection of cancer patients with cardiovascular disease in Japan by the year 2039: a pilot study

Yuji Okura  1 , Tsugumi Takayama  2 , Kazuyuki Ozaki  2 , Hiroshi Tanaka  3 , Akira Kikuchi  4 , Toshihiro Saito  5 , Toshiki Tanigawa  5 , Yasumasa Takii  6 , Hiroshi Seki  7 , Tatsuya Takenouchi  8 , Takaaki Chou  9 , Nobuaki Sato  10 , Naohito Tanabe  11 , Tohru Minamino  2
Affiliations

Future projection of cancer patients with cardiovascular disease in Japan by the year 2039: a pilot study

Yuji Okura et al. Int J Clin Oncol. 2019 Aug.

Erratum in

Abstract

Background: The number of cancer patients in Japan is estimated to rise to 3.5 million by 2025. The disease burden may be further complicated by comorbidities caused by cardiovascular disease (CVD). Predicting the number of cancer patients with CVD can help anticipate future resource needs.

Methods: We used statistics derived from the Niigata Cancer Center CVD Study (2015) as well as population estimates from the National Cancer Center's Cancer Registry and Statistics survey of 2017 for convenience. We simply multiplied the projected number of cancer patients through the year 2039 by the CVD prevalence in 2015, with patients classified by sex, age, and cancer type to estimate the number of cancer patients with CVD.

Results: The total number of Japanese cancer patients with CVD was 253,000 in 2015 and is predicted to increase rapidly by 30,000 in 2020 and peak at 313,000 in 2030-2034. Men will dominate the CVD population at 2.5-fold the number of women. The growth rate of the population with both cancer and CVD will be greater than that of the cancer-only population (1.23 vs 1.18, P < 0.001), and will comprise notably high proportions of patients with prostatic, breast, and uterine cancers (1.80, 1.57, and 1.66, P < 0.001, respectively).

Conclusion: Future cancer patients will be older and more likely to have CVD. Although men will continue to dominate this population, the increase in the number of women will be pronounced. Cancer care providers should be trained to recognize CVD and provide any necessary interventions concurrently with cancer therapy.

Keywords: Cancer; Cardiovascular disease; Comorbidity; Epidemiology; Prediction models.

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Conflict of interest statement

No author has any conflict of interest.

Figures

Fig. 1
Fig. 1
Projected number of cancer patients between 2015 and 2039. Bar graphs show the number of cancer patients in total and with each CVD stratified by 5-year intervals. The numbers of cancer patients are the sum of “all (C00–C96)” lines listed in Supplementary Table 1. The numbers of cancer patients with CVD are listed in the “total” categories of Supplementary Table 3. AF, atrial fibrillation; AS, aortic stenosis; CVD, cardiovascular disease; IHD, ischemic heart disease; LVD, left ventricular dysfunction; LVDD, left ventricular diastolic dysfunction; LVSD, left ventricular systolic dysfunction; NT-proBNP, N-terminal pro-brain natriuretic peptide; VTE, venous thromboembolism
Fig. 1
Fig. 1
Projected number of cancer patients between 2015 and 2039. Bar graphs show the number of cancer patients in total and with each CVD stratified by 5-year intervals. The numbers of cancer patients are the sum of “all (C00–C96)” lines listed in Supplementary Table 1. The numbers of cancer patients with CVD are listed in the “total” categories of Supplementary Table 3. AF, atrial fibrillation; AS, aortic stenosis; CVD, cardiovascular disease; IHD, ischemic heart disease; LVD, left ventricular dysfunction; LVDD, left ventricular diastolic dysfunction; LVSD, left ventricular systolic dysfunction; NT-proBNP, N-terminal pro-brain natriuretic peptide; VTE, venous thromboembolism
Fig. 2
Fig. 2
Proportions of the top 7 cancer types in 2015–2019 and 2035–2039 in cancer patients with each type of CVD. The numbers of cancer patients are the sum of each categories from ‘Oral cavity & pharynx’ (C00–C14) to ‘Leukemia’ (C91–C95) listed in Supplementary Table 3. The numbers of cancer patients with CVD are listed in the “total” categories of Supplementary Table 3. According to Japanese national cancer statistics, there were 1.7 million male cancer patients and 1.4 million female cancer patients in 2015; the numbers are expected to be 1.9 million and 1.7 million in 2025, respectively (Supplementary Table 1). To compare the proportion of cancer types, we summed the number of patients with each cancer and considered the total to be the denominator. Accordingly, the number of cancer patients listed here was larger than those of Japanese national cancer statistics. AF atrial fibrillation, AS aortic stenosis, CVD cardiovascular disease, IHD ischemic heart disease, LVD left ventricular dysfunction, LVDD left ventricular diastolic dysfunction, LVSD left ventricular systolic dysfunction, NT-proBNP N-terminal pro-brain natriuretic peptide, VTE venous thromboembolism
Fig. 2
Fig. 2
Proportions of the top 7 cancer types in 2015–2019 and 2035–2039 in cancer patients with each type of CVD. The numbers of cancer patients are the sum of each categories from ‘Oral cavity & pharynx’ (C00–C14) to ‘Leukemia’ (C91–C95) listed in Supplementary Table 3. The numbers of cancer patients with CVD are listed in the “total” categories of Supplementary Table 3. According to Japanese national cancer statistics, there were 1.7 million male cancer patients and 1.4 million female cancer patients in 2015; the numbers are expected to be 1.9 million and 1.7 million in 2025, respectively (Supplementary Table 1). To compare the proportion of cancer types, we summed the number of patients with each cancer and considered the total to be the denominator. Accordingly, the number of cancer patients listed here was larger than those of Japanese national cancer statistics. AF atrial fibrillation, AS aortic stenosis, CVD cardiovascular disease, IHD ischemic heart disease, LVD left ventricular dysfunction, LVDD left ventricular diastolic dysfunction, LVSD left ventricular systolic dysfunction, NT-proBNP N-terminal pro-brain natriuretic peptide, VTE venous thromboembolism
Fig. 3
Fig. 3
Sex-, and cancer type-specific projected number of CVDs for the top 10 cancers, 2015–2039. Bar graphs show the number of cancer patients with CVD stratified by 5-year intervals. The top 10 is not a ranking in all cancers but of cancers with CVD in 2015. CVD, cardiovascular disease
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