Cardiovascular disease in patients living with cancer

Cancer is one of the most important causes of ill-health and death in the world. Fortunately, medical advances have steadily improved successful treatment of cancers. As a result, many more patients are surviving cancer and living to older ages.

We know from previous research that exposure to cancer treatments such as chemotherapy and radiotherapy increases the risk of developing heart disease. Indeed, existing research shows that people with previous cancer have higher risk of developing important heart diseases such as, heart attacks and strokes. These conditions are a growing cause of disability and premature death in cancer survivors. It is important that we understand how to best support the heart health of patients with previous cancers. To do that, we need high quality data from large populations. Importantly, we need to better understand what types of heart diseases affect people with past cancer and how commonly they occur. However, there are few such reports in existing work. One of the key ways to prevent heart disease is by controlling major risk factors such as, high blood pressure and cholesterol. There may be barriers to treatment of these risk factors in patients with past cancer; however, this has not been formally studied as yet. A further important consideration is health inequalities associated with socio-economic deprivation or ethnicity. It is not known whether and how experiences of heart disease in people with past cancer are influenced by health inequalities. Our proposed project will be a first step towards improving our understanding of the cardiovascular healthcare needs of cancer survivors and will provide insights into healthcare inequalities in this context.

The study will use routinely collected general practice (GP) data from over 1.2 million people registered with GPs across east London. This region comprises a multi-ethnic urban population with some of the highest levels of deprivation in the country. First, we will characterise the burden of heart disease in people with past cancer within our study population. Second, we will examine whether cancer survivors with important risk factors for heart disease are appropriately treated; we will focus on management of high blood pressure and cholesterol as the most important risk factors. Third, we will examine the impact of health inequalities (ethnicity, deprivation level) on the burden and management of heart diseases in the context of previous cancer. In summary, our work will provide new insight into types and frequency of heart diseases in cancer survivors, identify gaps in management of key risk factors, and evaluate the influence of health inequalities. This work will provide direction for further research, identify specific targets for disease prevention/treatment, and inform planning of healthcare services to ultimately improve the heart health of people with past cancer.

Amount Awarded: £49,692