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Gynecol Oncol. 2018 Jan;148(1):154-160. doi: 10.1016/j.ygyno.2017.11.019. Epub 2017 Nov 24.

The unrecognized burden of cardiovascular risk factors in women newly diagnosed with endometrial cancer: A prospective case control study.

Author information

1
Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester M13 9WL, United Kingdom.
2
Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester M13 9PL, United Kingdom.
3
Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester M13 9WL, United Kingdom; Department of Obstetrics and Gynaecology, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, United Kingdom.
4
Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, United Kingdom; Manchester Diabetes Centre, 193 Hathersage Road, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 0JE, United Kingdom.
5
Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester M13 9WL, United Kingdom; Department of Obstetrics and Gynaecology, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, United Kingdom. Electronic address: emma.crosbie@manchester.ac.uk.

Abstract

BACKGROUND:

Cardiovascular disease is a major cause of death in endometrial cancer survivors. The aim of this study was to determine whether women newly diagnosed with endometrial cancer have a higher prevalence of cardiovascular risk factors than the general population.

METHODS:

The prevalence of adequately treated and unrecognized/inadequately treated cardiovascular risk factors and the corresponding 10-year cardiovascular risk by QRISK2 score was measured in 150 consecutive women undergoing primary treatment for endometrioid endometrial cancer in the North West of England, and 746 age and ethnicity-matched control women from the Health Survey for England 2014.

RESULTS:

Women with endometrial cancer had higher proportions of obesity (BMI≥30 60.7% vs. 32.4%, p<0.0001) and a preponderance of unrecognized and inadequately treated cardiovascular risk factors. Compared with controls, endometrial cancer cases had a higher prevalence of incident hyperglycemia (57.2%vs.11.5%, p<0.0001), total: HDL cholesterol ratio>4.5 (26.7%vs.13.7%, p<0.0001), and were more likely to have three or more cardiovascular risk factors (22%vs.6%, p<0.0001). This equates to a higher 10-year cardiovascular risk (median QRISK2 score 12.6% vs. 8.8%, p<0.0001). Optimization of risk factors would have a greater impact on absolute cardiovascular disease risk for cases than controls (QRISK2 score reduction 1.8% vs. 0.7%).

CONCLUSIONS:

Women undergoing primary treatment for endometrial cancer have a higher prevalence of cardiovascular risk factors than women without the disease. Early identification and treatment of these risk factors could improve outcomes for endometrial cancer survivors.

KEYWORDS:

Cardiovascular disease; Endometrial cancer; Hypercholesterolemia; Hyperglycemia; Hypertension; Obesity; QRISK2; Survival

PMID:
29174567
DOI:
10.1016/j.ygyno.2017.11.019
[Indexed for MEDLINE]
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