The unrecognized burden of cardiovascular risk factors in women newly diagnosed with endometrial cancer: A prospective case control study |
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Authors: | Sarah J. Kitson Jennifer Lindsay Vanitha N. Sivalingam Mark Lunt Neil A.J. Ryan Richard J. Edmondson Martin K. Rutter Emma J. Crosbie |
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Affiliation: | 1. Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary''s Hospital, Manchester M13 9WL, United Kingdom;2. Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester M13 9PL, United Kingdom;3. Department of Obstetrics and Gynaecology, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, United Kingdom;4. Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, United Kingdom;5. Manchester Diabetes Centre, 193 Hathersage Road, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 0JE, United Kingdom |
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Abstract: | BackgroundCardiovascular disease is a major cause of death in endometrial cancer survivors. The aim of this study was to determine whether women newly diagnosed with endometrial cancer have a higher prevalence of cardiovascular risk factors than the general population.MethodsThe prevalence of adequately treated and unrecognized/inadequately treated cardiovascular risk factors and the corresponding 10-year cardiovascular risk by QRISK2 score was measured in 150 consecutive women undergoing primary treatment for endometrioid endometrial cancer in the North West of England, and 746 age and ethnicity-matched control women from the Health Survey for England 2014.ResultsWomen with endometrial cancer had higher proportions of obesity (BMI ≥ 30 60.7% vs. 32.4%, p < 0.0001) and a preponderance of unrecognized and inadequately treated cardiovascular risk factors. Compared with controls, endometrial cancer cases had a higher prevalence of incident hyperglycemia (57.2% vs. 11.5%, p < 0.0001), total: HDL cholesterol ratio > 4.5 (26.7% vs. 13.7%, p < 0.0001), and were more likely to have three or more cardiovascular risk factors (22% vs. 6%, p < 0.0001). This equates to a higher 10-year cardiovascular risk (median QRISK2 score 12.6% vs. 8.8%, p < 0.0001). Optimization of risk factors would have a greater impact on absolute cardiovascular disease risk for cases than controls (QRISK2 score reduction 1.8% vs. 0.7%).ConclusionsWomen undergoing primary treatment for endometrial cancer have a higher prevalence of cardiovascular risk factors than women without the disease. Early identification and treatment of these risk factors could improve outcomes for endometrial cancer survivors. |
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Keywords: | Endometrial cancer Obesity Hyperglycemia Hypertension Hypercholesterolemia Cardiovascular disease QRISK2 Survival |
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