Female, Young Adult Cancer Survivors and Cardiometabolic Health Public

Abstract

Due to improvements in cancer treatments and new technologies, the survival rate for individuals diagnosed with cancer has increased. Thus, there is a growing population of cancer survivors. While some studies have focused on the health of childhood cancer survivors after treatment has ended, there is a need for research related to the long-term cardiometabolic health of reproductive-aged women in the U.S. We used data from the Furthering Understanding of Cancer Health and Survivorship in Adult (FUCHSIA) Women’s Study. The FUCHSIA Women’s Study includes 1282 cancer survivors and 1073 women who were never diagnosed with cancer. We considered three outcomes in the study: any cardiovascular outcome (chronic hypertension or high blood pressure, congestive heart failure or cardiomyopathy, or heart attack or myocardial infarction), diabetes, and any cardiometabolic outcome (any cardiovascular outcome or diabetes). We performed adjusted logistic regression to examine the relationship between cancer diagnosis and development of the three outcomes. We controlled for potential confounders including: race, education, income, cigarette smoking, and age at interview. We repeated these analyses restricted to 1) breast cancer survivors, 2) survivors who had radiation to the chest (described as survivors who were diagnosed with breast cancer or lung cancer and received radiation), 3) survivors who were treated with chemotherapy, and 4) survivors who had both radiation to the chest and chemotherapy treatment. In the unadjusted model for all cancer survivors compared with those who were never diagnosed with cancer, the odds ratio (OR) for diabetes was 1.26 (95% CI:0.83, 1.90), for any cardiovascular outcome was 1.24 (95% CI:0.98, 1.57), and for any cardiometabolic outcome was 1.22 (95% CI:0.97, 1.52). The adjusted results for all models were null. Among those treated with chemotherapy, in the unadjusted model, the odds of all outcomes was slightly greater among cancer survivors, compared to those who were never diagnosed with cancer. However, after adjusting for confounders, the OR for all outcomes were null among those treated with chemotherapy. These results should be interpreted with caution but provide modest reassurance that cancer and its treatments broadly may not increase the risk of cardiometabolic outcomes in reproductive-aged women.

Table of Contents

  Chapter                                                                                                   Page

1     Background...............................................................................1

            Introduction.........................................................................1

            Cancer in Young Adult Women................................................1

            Cardiometabolic Health..........................................................3

            Cancer and Cardiometabolic Health.........................................4

            Effects of Chemotherapy on Cardiometabolic Health..................5

            Effects of Radiation on Cardiometabolic Health.........................6

            Total Body Irradiation and Stem Cell Transplantation.................7

            Other Factors that Influence Cardiometabolic Health and 

            Intervention Efforts...............................................................8

            Summary and Research Question............................................8

            References.........................................................................10

            Table 1.1............................................................................16

 

2     Female, Young Adult Cancer Survivors and Cardiometabolic Health...18

             Introduction........................................................................18

             Methods..............................................................................20

                   Study Population.............................................................20

                   Statistical Analyses..........................................................22

             Results.................................................................................23

             Discussion............................................................................25

             References............................................................................29

             Table 2.1..............................................................................33

             Table 2.2..............................................................................36

             Table 2.3..............................................................................38

             Appendix..............................................................................40

                  Supplemental Table...........................................................40

 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Mot-clé	epidemiology cardiometabolic risk factors cancer
Committee Chair / Thesis Advisor	Howards, Penelope, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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