The Risk of Cardiovascular Disease Among Ovarian Cancer Survivors

Background: Very few studies have investigated cardiovascular disease (CVD) risk among ovarian cancer survivors in a population-based study. We aimed to estimate CVD risk among ovarian cancer survivors compared to women from the general population in a population-based study. Methods: A cohort of 1,271 patients with ovarian cancer diagnosed from 1996 to 2012 in the Utah Cancer Registry and 5,289 age-matched women from the general population in the Utah Population Database was identified. CVD outcomes were available in electronic medical records and statewide healthcare facilities data. Cox Proportional Hazards models were used to estimate hazard ratios (HRs) for CVD at 1-5 years and >5 years after the index date. Findings:  Increased risks were observed 1-5 years after cancer diagnosis for ovarian cancer survivors in comparison with the general population for hypertension (HR=1·14, 95% CI, 1·01-1·29), cerebrovascular disease (HR=1·42, 95% CI, 1·06-1·89), and diseases of the heart (HR=1·81, 95% CI, 1·60-2·04), the arteries (HR=1·97, 95% CI, 1·67-2·33), and the veins and lymphatics (HR=2·75, 95% CI, 2·36-3·22). Elevated risks were still observed for diseases of the arteries (HR=1·31, 95% CI, 1·06-1·61) and the veins and lymphatics (HR=1·80, 95% CI, 1·48-2·18) >5 years after cancer diagnosis.   Interpretation:  Ovarian cancer survivors had higher risks of several CVD outcomes compared with women from the general population. The results support the consideration of monitoring and/or initiation of primary prevention for CVD outcomes among ovarian cancer survivors. Funding: This work was supported by a grant from the NCI (R21 CA185811), the Marian Bishop Award from the Department of Family and Preventive Medicine at the University of Utah and the NCRR grant, “Sharing Statewide Health Data for Genetic Research” (R01 RR021746, G. Mineau, PI) with additional support from the Utah State Department of Health and the University of Utah. Declaration of Interests: None reported. Ethics Approval Statement: We obtained approval from the University of Utah’s Resource for Genetic and Epidemiologic Research (UPDB oversight committee) and the University of Utah Institutional Review Board.