亚裔、夏威夷原住民和太平洋岛民老年肝癌幸存者的心血管疾病发病风险。

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology Pub Date : 2024-10-02 DOI:10.1016/j.canep.2024.102680

Jing Wang , Yancen Pan , Chun-Pin Esther Chang , Anees Daud , Randa Tao , Mia Hashibe

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引用次数: 0

摘要

背景：心血管疾病（CVD）是全球关注的重大健康问题，尤其是在面临独特健康挑战的亚裔、夏威夷原住民和太平洋岛民（ANHPI）群体中。肝癌不成比例地影响着亚裔夏威夷及太平洋岛民群体，由于共同的病理生理机制和代谢紊乱，肝癌与心血管疾病风险有着错综复杂的联系。然而，ANHPI 肝癌患者的具体心血管疾病风险概况仍鲜为人知：我们利用监测、流行病学和最终结果（SEER）-医疗保险数据，确定并匹配了 1150 名 ANHPI 和 2070 名在 2000 年至 2017 年期间确诊的非西班牙裔白人（NHW）肝癌患者。我们使用 Fine-Gray 亚分布危险模型估算了 ANHPI 肝癌患者与 NHW 患者以及 ANHPI 亚组之间的心血管疾病（包括缺血性心脏病 (IHD)、心力衰竭和中风）风险的危险比 (HRs) 和 95 % 置信区间 (95 % CIs)：ANHPI肝癌患者的IHD风险低于NHW肝癌患者（HR, 0.65, 95 % CI, 0.50, 0.86），与更广泛的趋势一致。亚组分析显示，ANHPI人群内部存在明显的异质性，东南亚（HR，0.65，95 % CI，0.42，1.00）和中国患者（HR，0.53，95 % CI，0.33-0.83）的IHD风险低于NHW人群。然而，与华裔患者相比，夏威夷原住民和太平洋岛民肝癌患者发生心力衰竭（HR，3.16，95 % CI，1.35-7.39）和IHD（HR，5.64，95 % CI，2.19-14.53）的风险较高：我们的研究强调了ANHPI肝癌患者心血管疾病风险的复杂性。结论：我们的研究凸显了非裔美国人肝癌患者心血管疾病风险的复杂性，解决这些差异对于改善非裔美国人肝癌患者的心血管疾病预后和减轻心血管疾病负担至关重要。

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Incident cardiovascular disease risk among older Asian, Native Hawaiian and Pacific Islander liver cancer survivors

Background

Cardiovascular disease (CVD) is a significant global health concern, particularly among Asian, Native Hawaiian, and Pacific Islander (ANHPI) communities that face unique health challenges. Liver cancer disproportionately affects ANHPI populations and has intricate associations with CVD risks due to shared pathophysiological mechanisms and metabolic disturbances. However, the specific CVD risk profile of ANHPI liver cancer patients remains poorly understood.

Methods

Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we identified and matched 1150 ANHPI and 2070 Non-Hispanic White (NHW) liver cancer patients diagnosed between 2000 and 2017. We used the Fine-Gray sub-distribution hazard model to estimate hazard ratios (HRs) and 95 % confidence intervals (95 % CIs) for CVD risks, including ischemic heart disease (IHD), heart failure, and stroke, among ANHPI liver cancer patients compared to NHW counterparts and among ANHPI subgroups.

Results

ANHPI liver cancer patients demonstrated a lower risk of IHD compared to NHW counterparts (HR, 0.65, 95 % CI, 0.50, 0.86), aligning with broader trends. Subgroup analysis revealed notable heterogeneity within ANHPI populations, with Southeast Asian (HR, 0.65, 95 % CI, 0.42, 1.00) and Chinese patients (HR, 0.53, 95 % CI, 0.33–0.83) exhibiting lower IHD risks compared to their NHW counterparts. However, Native Hawaiian and Pacific Islander liver cancer patients showed elevated risks of heart failure (HR, 3.16, 95 % CI, 1.35–7.39) and IHD (HR, 5.64, 95 % CI, 2.19–14.53) compared to their Chinese counterparts.

Conclusion

Our study highlights the complexity of CVD risks among ANHPI liver cancer patients. Addressing these disparities is crucial for improving cardiovascular outcomes and reducing the burden of CVD among ANHPI liver cancer patients.

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来源期刊

Cancer Epidemiology 医学-肿瘤学

CiteScore

4.50

自引率

3.80%

发文量

200

审稿时长

39 days

期刊介绍： Cancer Epidemiology is dedicated to increasing understanding about cancer causes, prevention and control. The scope of the journal embraces all aspects of cancer epidemiology including: • Descriptive epidemiology • Studies of risk factors for disease initiation, development and prognosis • Screening and early detection • Prevention and control • Methodological issues The journal publishes original research articles (full length and short reports), systematic reviews and meta-analyses, editorials, commentaries and letters to the editor commenting on previously published research.