Cardiovascular health assessment in routine cancer follow-up in community settings: survivor risk awareness and perspectives

• Published in: BMC cancer Vol. 24; no. 1; p. 158
• Main Authors: Weaver, Kathryn E, Dressler, Emily V, Smith, Sydney, Nightingale, Chandylen L, Klepin, Heidi D, Lee, Simon Craddock, Wells, Brian J, Hundley, W Gregory, DeMari, Joseph A, Price, Sarah N, Foraker, Randi E
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 31.01.2024; BioMed Central; BMC
• Subjects: Blood Pressure; Body mass index; Breast cancer; Breast Neoplasms; Cancer; Cancer survivors; Cancer survivorship; Cancer therapies; Cardiotoxicity; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Care and treatment; Care delivery model; Cholesterol; Clinical Trials as Topic; Comorbidity; Cross-Sectional Studies; Dextrose; Diabetes; Diabetes mellitus; Diagnosis; Electronic Health Records; Electronic records; Exercise; Female; Follow-Up Studies; Glucose; Glycosylated hemoglobin; Health aspects; Health risk assessment; Health Status; Heart; Hemoglobin; Humans; Hyperlipidemia; Hypertension; Lifestyle risk factors; Male; Medical records; Methods; Obesity; Oncology; Oncology, Experimental; Patients; Physical activity; Prevention; Primary care; Prostate; Risk Assessment; Risk Factors; Smoking; Survivors; United States; Web portals; United States; Lifestyle risk factors; Care delivery model; Electronic Health Records; Cancer survivorship
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-024-11912-8

Guidelines recommend cardiovascular risk assessment and counseling for cancer survivors. For effective implementation, it is critical to understand survivor cardiovascular health (CVH) profiles and perspectives in community settings. We aimed to (1) Assess survivor CVH profiles, (2) compare self-reported and EHR-based categorization of CVH factors, and (3) describe perceptions regarding addressing CVH during oncology encounters. This cross-sectional analysis utilized data from an ongoing NCI Community Oncology Research Program trial of an EHR heart health tool for cancer survivors (WF-1804CD). Survivors presenting for routine care after potentially curative treatment recruited from 8 oncology practices completed a pre-visit survey, including American Heart Association Simple 7 CVH factors (classified as ideal, intermediate, or poor). Medical record abstraction ascertained CVD risk factors and cancer characteristics. Likert-type questions assessed desired discussion during oncology care. Of 502 enrolled survivors (95.6% female; mean time since diagnosis = 4.2 years), most had breast cancer (79.7%). Many survivors had common cardiovascular comorbidities, including high cholesterol (48.3%), hypertension or high BP (47.8%) obesity (33.1%), and diabetes (20.5%); 30.5% of survivors received high cardiotoxicity potential cancer treatment. Less than half had ideal/non-missing levels for physical activity (48.0%), BMI (18.9%), cholesterol (17.9%), blood pressure (14.1%), healthy diet (11.0%), and glucose/ HbA1c (6.0%). While > 50% of survivors had concordant EHR-self-report categorization for smoking, BMI, and blood pressure; cholesterol, glucose, and A1C were unknown by survivors and/or missing in the EHR for most. Most survivors agreed oncology providers should talk about heart health (78.9%). Tools to promote CVH discussion can fill gaps in CVH knowledge and are likely to be well-received by survivors in community settings. NCT03935282, Registered 10/01/2020.