Teenage and young adult cancer survivors, particularly those with lymphoma, appear to be at high risk of developing heart disease associated with cancer treatments, a large-scale study in the U.K. reports.
The study, “Cardiac Mortality Among 200,000 Five-Year Survivors of Cancer Diagnosed Aged 15-39 Years: The Teenage and Young Adult Cancer Survivor Study,” was published in Circulation, the journal of the American Heart Association. It stressed that young age for a Hodgkin’s lymphoma diagnosis was linked to a 3.8 times higher risk of death from heart disease in middle-age.
Researchers analyzed data on more than 200,000 U.K. cancer patients, diagnosed at ages 15 to 39, who survived at least five years after diagnosis. Of this group, 2,016 — or 6 percent — died of heart disease, defined as ischemic heart disease, valvular heart disease, and cardiomyopathy.
The team found that patients diagnosed at 15 to 19 years old had about four times the risk of dying of heart disease compared to individuals of the same age and gender in the general population. Those diagnosed at 35 to 39 years of age, in comparison, had 1.2-fold higher risk compared to the general population.
Among survivors of Hodgkin’s lymphoma, in particular, 6.9 percent of those diagnosed at ages 15 to 19 died of heart disease by age 55, compared to 2 percent of lymphoma survivors diagnosed at ages 35 to 39.
Overall, lymphoma survivors had a 3.8 percent higher risk of death due to heart disease than people in general of the same age and gender. Among lymphoma survivors older than age 60, almost 30 percent of noncancer-related deaths were due to heart disease.
Cardiac disease was also higher in patients, diagnosed at ages 15 to 19, with cancers that included leukemia, genitourinary cancer (other than bladder cancer), non-Hodgkin’s lymphoma, lung cancer, and breast cancer. The risk, again, decreased as the person’s age at diagnosis rose.
These results underscore the toxicity to the heart associated with cancer treatments given to teenager and young adult patients, the researchers said.
“It is important for clinicians because it helps them focus the most intensive follow-up care on those most at risk,” Mike Hawkins, PhD, the study’s senior author, said in a news release. “It is important for survivors because it empowers them by providing them with their long-term chances of a specific side effect of cancer treatment.”
“Survivors of cancer diagnosed in teenage and young adulthood are internationally acknowledged to be an under studied population,” he added. “With the advantage of long-standing cancer registration for the U.K. population, we were in a position to undertake the largest study to date, which has the advantage of being population-based and benefits from lengthy follow-up after diagnosis.”