Abstract 14896: Cardiovascular Events and Healthcare Utilization Among Long-term Adult Cancer Survivors Relative to Comorbidity-matched Controls

Background: Adult cancer survivors have higher rates of cardiovascular disease (CVD) and healthcare utilization (HCU) relative to the general population, but also have a greater burden of CVD risk factors and comorbidities. To what degree these differences are attributable to established comorbidities versus factors related to cancer survivorship, per se, is unknown. To determine whether rates of CVD and HCU among survivors is out of proportion to the magnitude of known risk factors, we compared rates of CVD and HCU in a large cohort of adult cancer survivors with comorbidity-matched controls. Methods: Adult survivors were identified from the Vanderbilt University Medical Center (VUMC) Cancer Registry. Clinical data were obtained through linkage with a de-identified version of the VUMC electronic health record, and subjects were matched 3:1 to controls based on age, race, and comorbidities. Association between cancer survivorship and CVD (defined as composite outcome of AMI, CVA/TIA, and CHF) was assessed using the log-rank test. Logistic regression was performed incorporating cardiac risk factors as covariates. Standardized incidence ratios were used to compare HCU (defined as median inpatient visits and length of stay). Results: A total of 19,881 adult cancer survivors were included in the analysis. During a median follow up of 12.9 years, cancer survivorship was significantly associated with increased risk of CVD (49 events per 100 person-years vs 27; HR 2.03, 95% CI: 1.92-2.16, p Conclusion: Adult cancer survivors have more CVD and HCU relative to comorbidity matched controls. Further studies are needed to determine what additional factors confer risk to survivors.