Raised cardiovascular disease mortality after central nervous system tumor diagnosis: analysis of 171,926 patients from UK and USA
Open Access
- 21 September 2021
- journal article
- research article
- Published by Oxford University Press (OUP) in Neuro-Oncology Advances
- Vol. 3 (1), vdab136
- https://doi.org/10.1093/noajnl/vdab136
Abstract
Patients with central nervous system (CNS) tumors may be at risk of dying from cardiovascular disease (CVD). We examined CVD mortality risk in patients with different histological subtypes of CNS tumors. We analyzed UK(Wales)-based Secure Anonymized Information Linkage (SAIL) for 8743 CNS tumors patients diagnosed in 2000–2015, and US-based National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) for 163,183 patients in 2005–2015. We calculated age-, sex-, and calendar-year-adjusted standardized mortality ratios (SMRs) for CVD comparing CNS tumor patients to Wales and US residents. We used Cox regression models to examine factors associated with CVD mortality among CNS tumor patients. CVD was the second leading cause of death for CNS tumor patients in SAIL (UK) and SEER (US). Patients with CNS tumors had higher CVD mortality than the general population (SAIL SMR = 2.64, 95% CI = 2.39–2.90, SEER SMR = 1.38, 95% CI = 1.35–1.42). Malignant CNS tumor patients had over 2-fold higher mortality risk in US and UK cohorts. SMRs for nonmalignant tumors were almost 2-fold higher in SAIL than in SEER. CVD mortality risk particularly cerebrovascular disease was substantially greater in patients diagnosed at age younger than 50 years, and within the first year after their cancer diagnosis (SAIL SMR = 2.98, 95% CI = 2.39–3.66, SEER SMR = 2.14, 95% CI = 2.03–2.25). Age, sex, race/ethnicity in USA, deprivation in UK and no surgery were associated with CVD mortality. Patients with CNS tumors had higher risk for CVD mortality, particularly from cerebrovascular disease compared to the general population, supporting further research to improve mortality outcomes.Keywords
Funding Information
- Brain Cancer Centre of Excellence Award (C157/A27589)
- Cancer Research UK
This publication has 38 references indexed in Scilit:
- Epidemiology of meningiomasNeurochirurgie, 2018
- Excess Mortality and Morbidity in Patients with Craniopharyngioma, Especially in Patients with Childhood Onset: A Population-Based Study in SwedenJournal of Clinical Endocrinology & Metabolism, 2015
- The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studiesInternational Journal of Surgery, 2014
- Development and use of a privacy-protecting total population record linkage system to support observational, interventional, and policy relevant researchThe Lancet, 2012
- Impaired survival and long-term neurological problems in benign meningiomaNeuro-Oncology, 2012
- Long‐term non‐cancer mortality in pediatric and young adult cancer survivors in FinlandPediatric Blood & Cancer, 2011
- Incidental Findings on Brain MRI in the General PopulationThe New England Journal of Medicine, 2007
- The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studiesPreventive Medicine, 2007
- Cerebrovascular disease in patients with pituitary tumorsTrends in Endocrinology & Metabolism, 2005
- Radiotherapy plus Concomitant and Adjuvant Temozolomide for GlioblastomaThe New England Journal of Medicine, 2005