First long-term study results presented: publication in the European Heart Journal
People who have been diagnosed with cancer as a child or adolescent have an increased risk of developing high blood pressure and fat metabolism disorder as adults. In addition, they have an almost double increase in risk for cardiovascular diseases. This is the result of the first long-term study, which systematically investigated the health and especially the long-term cardiovascular consequences of cancer in childhood and adolescence and compared it with the German general population. The results of the Mainz CVSS study were published today in the prestigious European Heart Journal.
On average, hypertension and fat metabolism disorders occurred more frequently and earlier (6 and 8 years) than in the general population. Cardiovascular diseases showed up at 4.5 percent of long-term survivors – most of them already at the age of 40. This is almost eight years earlier than in the rest of the population. In order to reach these results, scientists of the University of Medicine Mainz studied in the framework of the CVSS study ("Cardiac and vascular late sequelae in long-term survivors of childhood cancer") between October 2013 and February 2016 a total of 951 adults who Were diagnosed with cancer as a child or teenager. They conducted clinical investigations, collected information about the then cancer therapy, and asked the subjects whether they smoked and whether there were cardiovascular diseases in the family. The study participants were between 23 and 48 years old at the time of the examination. Their findings were compared with those of 15,000 people from the rest of the population.
Univ.-Prof. Dr. Jörg Faber, head of the Pediatric Oncology Center in the University Center for Tumor Diseases (UCT Mainz), one of three study leaders and first author of the present publication, underlines: "Our results show that earlier Cancer patients have a substantially higher risk of developing classical risk factors for cardiovascular diseases such as hypertension and fat metabolism disorders at a relatively early age, i.e. in young adulthood. " Univ.-Prof. Dr. Philipp Wild, head of the Department of Preventive Cardiology and medical prevention, also CVSS-head of studies and senior author of the work adds: "In addition, with nearly 80 percent of the affected – 207 out of 269 – increased fat levels are only The clinical examinations associated with the study and which had previously been unrecognized. " A similar picture has arisen in hypertension.
On the basis of the lessons learned, it is now necessary to avoid these late consequences as far as possible. "And that is possible," Professor Faber is convinced: "Early screening, which in particular focuses on high blood pressure and increased fat levels, should become an integral part of a structured cancer aftercare – regardless of the cancer ." The fact that a hypertension develops a cardiovascular disease could be prevented at an early stage, for example, by changing lifestyles or using blood pressure medications. The previous aftercare is only for five to ten years – and is mainly aimed at avoiding the recurrence of cancer. In addition, current guidelines recommend regular cardiovascular examinations only for very specific tumor types. "In order to develop an optimal aftercare strategy, however, further studies are needed", emphasizes Univ.-Prof. Dr. Maria Blettner, director of the Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), also head of the CVSS study and author of this work.
The researchers now want to take a closer look at the precise mechanisms by which former cancer patients develop cardiovascular symptoms. It is known, for example, that chemotherapy or irradiation in the context of a cancer treatment can damage heart cells as well as blood vessels temporarily or even permanently. The assumption is that certain genetic factors also play a role here. The authors of the study said that "this should be further elucidated by means of detailed further investigations at the molecular level."
Original Paper
Burden of cardiovascular risk factors and cardiovascular disease in childhood cancer survivors: data from the German CVSS-study
J. Faber, A. Wingerter, M.A.Neu, N. Henninger, S. Eckerle, T.Münzel,K.J. Lackner, M.E. Beutel, M. Blettner,W. Rathmann, A. Peters, C. Meisinger, B. Linkohr, H. Neuhauser, P. Kaatsch, C. Spix, A. Schneider, H. Merzenich, M. Panova-Noeva, J.H. Prochaska and P.S. Wild
European Heart Journal, ehy026
doi.org/10.1093/eurheartj/ehy026
Press Release Public Relations University Medical Center Mainz