JNCI Cancer Spectr. 2025 Dec 17:pkaf117. doi: 10.1093/jncics/pkaf117. Online ahead of print.
ABSTRACT
BACKGROUND: Cardiometabolic risk factors (CMRF) and cardiovascular disease (CVD) incidence in racially and ethnically underrepresented women with breast cancer (BC) are not well characterized.
METHODS: The Pathways Heart Study is a prospective cohort of 14,942 women diagnosed with invasive BC from 2005-2013 at Kaiser Permanente Northern California. Incidence of CMRF and CVD outcomes was determined from electronic records and calculated with competing risk framework for non-CVD death. Fine-Gray proportional hazards regression estimated sub-distribution hazard ratios by race and ethnicity compared with non-Hispanic White (NHW) women, with additional Asian subgroup analysis.
RESULTS: Participants were on average 61 years old at diagnosis and 65% NHW, 7.5% Black, 14.4% Asian, 11.9% Hispanic, 0.4% Pacific Islander, and 0.8% American Indian/Alaska Native. Black and Asian women had 1.2-1.3-times higher incident hypertension risk; Black, Asian, Hispanic, and Pacific Islander women had 1.5-3-times higher incident diabetes risk; Asian women had 1.2-times higher incident dyslipidemia risk.Black women had 1.3-1.4-times higher risk of incident ischemic heart disease (IHD), heart failure (HF) and overall CVD. Filipino women had 1.6-times higher risk of stroke. South Asian women had 2.5-2.6-times higher IHD and HF risk.
CONCLUSIONS: Compared with NHW women, racially and ethnically diverse women with BC experienced higher risk of incident diabetes, hypertension, and dyslipidemia. Black and Asian women, particularly Filipino and South Asian, had higher risk of incident CVD. Better characterization of health disparities in cardio-oncology is critical to inform future CVD prevention and treatment.
PMID:41405835 | DOI:10.1093/jncics/pkaf117