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Late effects of childhood cancer: increased risk of cardiovascular disease


Children with cancer have a higher risk of cardiovascular disease than adults

More and more people survive cancer. Once the disease is over, however, it can still have long-term consequences years later. A new study showed that people who had cancer in childhood have an increased risk of cardiovascular disease as adults.

More and more young people are also getting cancer

It is mainly older people who get cancer, but scientific studies have shown that more and more cancers can be seen among teenagers. And even new cancer cases in children are increasing dramatically, according to researchers. Thanks to medical advances, more and more patients are surviving their illness. Nevertheless, they have to reckon with late consequences in later life. This is also made clear by the results of a German long-term study that was recently published in the "European Heart Journal".

Twice the risk of cardiovascular diseases

People who had cancer as a child or adolescent are at an increased risk of developing high blood pressure and a fat metabolism disorder as adults. In addition, they have an almost two-fold increased risk of cardiovascular diseases.

This is the result of the first long-term study, which systematically examined health and in particular the long-term cardiovascular consequences after cancer in childhood and adolescence and compared it with the German general population, reports the University Medicine of the Johannes Gutenberg University Mainz in a communication.

Accordingly, high blood pressure and lipid metabolism disorders occurred on average more often and earlier (six and eight years, respectively) than in the general population.

Cardiovascular diseases were found in 4.5 percent of long-term survivors - the majority of them under 40 years of age. This is almost eight years earlier than in the rest of the population.

Almost 1000 subjects who developed cancer early on

To reach these results, scientists from Mainz University Medical Center examined a total of 951 adults as children or adolescents between October 2013 and February 2016 as part of the CVSS study ("Cardiac and vascular late sequelae in long-term survivors of childhood cancer") had cancer.

The experts carried out clinical examinations, collected information about the cancer therapy at that time and asked the test subjects whether they smoked and whether there were already cardiovascular diseases in the family.

At the time of the study, the study participants were between 23 and 48 years old. Their test results were compared to those of 15,000 people from the rest of the population.

High blood pressure and fat metabolism disorders

Univ.-Prof. Dr. Jörg Faber, head of the Children's Oncology Center at the University Center for Tumor Diseases (UCT Mainz), one of three study leaders emphasizes:

"Our results show that previous cancer patients have a substantially higher risk of developing classic risk factors for cardiovascular diseases such as high blood pressure and lipid metabolism disorders relatively early, ie in young adulthood."

Univ.-Prof. Philipp Wild, Head of the Preventive Cardiology and Medical Prevention Department, also CVSS study leader and senior author of the work adds:

"In addition, almost 80 percent of those affected - namely 207 out of 269 - only found increased fat levels in the course of the clinical studies associated with the study and had previously remained undetected." A similar picture emerged with hypertension.

Avoid late effects if possible

Based on the knowledge gained, it is now important to avoid these long-term consequences as far as possible. "And that's possible," Professor Faber is convinced:

"Early screening programs, which focus in particular on high blood pressure and increased fat levels, should become an integral part of structured cancer follow-up - regardless of the type of cancer."

The fact that a cardiovascular disease develops from high blood pressure could then be prevented at an early stage, for example by changing one's lifestyle with a healthy diet and coping with stress, or with blood pressure medication.

Cancer treatment could damage heart cells and blood vessels

Follow-up care to date is only for five to ten years - and the main aim is to avoid the recurrence of the cancer. In addition, current guidelines recommend regular cardiovascular examinations only for very specific types of tumor.

"In order to develop an optimal aftercare strategy, however, further studies are required," emphasizes Univ.-Prof. Maria Blettner, director of the Institute for Medical Biometry, Epidemiology and Computer Science (IMBEI), also director of the CVSS study and author of this work.

The researchers are now also keen to focus on the exact mechanisms by which cardiovascular symptoms develop in former cancer patients.

For example, it is known that chemotherapy or radiation can temporarily or even permanently damage heart cells and blood vessels as part of cancer treatment. The assumption is that certain genetic factors also play a role here.

"This now applies it using detailed further studies at the molecular level closer to light," the study authors. (ad)

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Video: Get Empowered 3: Cardiac risk factors, prevention and late effects of childhood cancer (August 2020).