Incidence of cardiovascular disease up to 13 year after cancer diagnosis: A matched cohort study among 32 757 cancer survivors

We examined the incidence of cardiovascular disease (CVD) among 32 757 cancer survivors and age-, gender-, and geographically matched cancer-free controls during a follow-up period of 1-13 years, and explored whether CVD incidence differed by received cancer treatment, traditional cardiovascular risk factors, age, or gender. Adult 1-year cancer survivors without a history of CVD diagnosed with breast (n = 6762), prostate (n = 4504), non-Hodgkin (n = 1553), Hodgkin (n = 173), lung and trachea (n = 2661), basal cell carcinoma (BCC; n = 12 476), and colorectal (n = 4628) cancer during 1999-2011 were selected from the Netherlands Cancer Registry and matched to cancer-free controls without a history of CVD. Drug dispenses and hospitalizations from the PHARMO Database Network were used as proxy for CVD. Data were analyzed using Cox regression analyses. Prostate (HR: 1.17; 95% CI: 1.01-1.35) and lung and trachea (HR: 1.48; 95% CI: 1.10-1.97) cancer survivors had an increased risk for developing CVD compared to cancer-free controls. This increased risk among lung and trachea cancer survivors remained statistically significant after including traditional cardiovascular risk factors and cancer treatment information (HR: 1.41; 95% CI: 1.06-1.89). Among prostate cancer survivors, the increased risk of incident CVD was limited to those who received hormones and those without traditional cardiovascular risk factors. Breast, non-Hodgkin, BCC, and colorectal cancer survivors showed no increased CVD risk compared to cancer-free controls. There was an increased risk of incident CVD among prostate, and lung and trachea cancer survivors compared to age-, gender- and geographically matched cancer-free controls. Studies including longer follow-up periods are warranted to examine whether cancer survivors are at increased risk of long-term incident CVD.