Identificador persistente para citar o vincular este elemento: http://hdl.handle.net/10553/136800
Título: Associations between cardiometabolic comorbidities and mortality in adults with cancer: multinational cohort study
Autores/as: Dávila Batista, Verónica 
Viallon, Vivian
Fontvieille, Emma
Jansana, Anna
Kohls, Mirjam
Bondonno, Nicola P .
Tjønneland, Anne
Dahm, Christina C.
Antoniussen, Christian S.
Katzke, Verena
Bajrachaya, Rashmita
Schulze, Matthias B.
Agnoli, Claudia
Ricceri, Fulvio
Panico, Salvatore
Zamora-Ros, Raul
Rodriguez-Barranco, Miguel
Amiano, Pilar
Chirlaque, Maria-Dolores
Moreno-Iribas, Conchi
Papier, Keren
Tsilidis, Konstantinos K.
Aune, Dagfinn
Gunter, Marc J.
Weiderpass, Elisabete
Jenab, Mazda
Ferrari, Pietro
Freisling, Heinz
Clasificación UNESCO: 32 Ciencias médicas
320713 Oncología
320501 Cardiología
Fecha de publicación: 2025
Publicación seriada: BMJ Medicine
Resumen: OBJECTIVE To examine separate and joint associations between pre- existing cardiometabolic comorbidities and all cause and cause specific mortality in adults with cancer. DESIGN Multinational cohort study. SETTING Seven European countries from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, 1 January 1992 to 31 December 2013. PARTICIPANTS 26 987 participants (54% women) who developed a first primary cancer. 2113 had a history of type 2 diabetes, 1529 had a history of cardiovascular disease, and 531 had a history of both, at the time of diagnosis of cancer. MAIN OUTCOME MEASURES Hazard ratios (95% confidence intervals, CIs) for associations between pre- existing cardiometabolic comorbidities and all cause and cause specific mortality in adults with cancer, estimated with multivariable Cox regression models. Associations were also estimated by groups of five year relative survival of cancer (survival ≤40%, 40- 80%, and ≥80%) according to Surveillance, RESULTS At the time of diagnosis of cancer, 84.5% (n=22 814) of participants had no history of a cardiometabolic disease, 7.8% (n=2113) had a history of type 2 diabetes, 5.7% (n=1529) had a history of cardiovascular disease, and 2.0% (n=531) had a history of both cardiovascular disease and type 2 diabetes. 12 782 deaths (10 492 cancer deaths) occurred over a mean follow- up period of 7.2 years. After multivariable adjustments, pre- existing comorbidities were positively associated with all cause mortality, with hazard ratios 1.25 (95% CI 1.17 to 1.34), 1.30 (1.21 to 1.39), and 1.60 (1.42 to 1.80) for participants with type 2 diabetes, cardiovascular disease, or both, respectively, compared with participants with no cardiometabolic comorbidity. Corresponding hazard ratios for cancer specific mortality were 1.13 (95% CI 1.05 to 1.22), 1.13 (1.04 to 1.23), and 1.33 (1.16 to 1.53), respectively. Associations for all cause mortality were stronger among participants with cancers with a five year relative survival ≥80%. In a subsample, duration of type 2 diabetes (Pinteraction =0.73) or cardiovascular disease (Pinteraction =0.24), categorised as <5 years or ≥5 years, did not modify associations between these comorbidities and all cause mortality. CONCLUSIONS In this study, cardiovascular disease or type 2 diabetes, or a combination of both, before a diagnosis of cancer, was associated with increased mortality (all cause mortality, and cancer and cardiovascular disease specific mortality). These f indings support a direct role of cardiometabolic comorbidities on the prognosis of cancer.
URI: http://hdl.handle.net/10553/136800
ISSN: 2754-0413
DOI: 10.1136/bmjmed-2024-000909
Fuente: BMJ Medicine [eISSN 2754-0413], v. 4: e000909 (Febrero 2025)
Colección:Artículos
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