Abstract 15021: Racial Disparity in Cardiovascular Mortality Among U.S. Population With Cancer: Results From the Surveillance, Epidemiology, and End Results (SEER) Database
Background: Lung(LC), Prostate(PC), Breast(BC) and Colorectal(CC) cancer are the leading causes of cancer in the U.S adult population. Current data on racial disparities in cardiovascular mortality among patients with cancer is unknown.
Methods: We conducted a retrospective analysis of registry data obtained from National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database from 1983 to 2009. We included patients aged ≥ 18 years with diagnosis of LC, PC, BC or CC (N=3,521,988). χ2 tests were used to analyze proportion of deaths due to non-cancer causes. Racial differences in survival outcomes due to cardiovascular causes were assessed using Kaplan-Meier curves and Cox regression models.
Results: Mean age of study population was 66.2 ± 17.2 years. About 83.7% were Whites (W), 11.1% were Blacks (B) and 5.2% were Other minor races(O). We identified cardiovascular mortality as the leading cause of all non-cancer related deaths (All: 53%, PC: 55.2%, CC: 54.8%, BC: 52.6%, LC: 46.9%). There was a significant difference in cardiovascular mortality (% of non-cancer deaths) among different racial groups (W: 52.7%, B: 55.1%, O: 53.2%, p<0.0001). Blacks had increased cardiovascular mortality compared to other races in all cancer subtypes [CC (B: 56.4%, W: 54.7%, O: 53.1%); BC (B: 55.1%, W: 52.4%, O: 50.9%); PC (B: 56.9%, W: 54.9%, O: 56.2%); LC (B: 50.3%, W:46.3%, O:49.1%), p<0.0001]. Ten year survival in Blacks who died of cardiovascular causes was lower compared to Whites and other races (B: 34%, W: 42%, O: 42%, p<0.0001). Multivariable analysis demonstrated increased cardiovascular mortality in Blacks (Adjusted Hazard Ratio =1.264, 95% CI: 1.26-1.31) compared to other races.
Conclusions: Blacks with cancer had higher proportion of cardiovascular deaths and lower survival when compared to Whites and other races. Identification of disparities in cardiovascular mortality among racial minorities especially Blacks with cancer may help in the implementation of interventions and best practices to reduce the burden of cardiovascular disease in this population, where socioeconomic, environmental, and traditional CVD risk factors are closely linked to differences in cardiovascular outcomes.
- © 2013 by American Heart Association, Inc.