Cardiovascular Screening Can Identify Toxic Effects in Adult Cancer Survivors

Researchers at the St. Jude Children’s Research Hospital conducted a study in 1853 adult survivors of childhood cancer over the age of 18 years who received cancer-related cardiotoxic therapy at least 10 years earlier. The primary outcome of the study was to assess cardiac outcomes among these survivors. The study, published in the Annals of Internal Medicine, identified considerable subclinical disease in the study group.

With an equal distribution of male and female survivors, the study cohort identified cardiomyopathy in 7.4% of survivors, coronary artery disease in 3.8% of survivors, valvular regurgitation or stenosis in 28%, and conduction or rhythm abnormalities in 4.4% of survivors. Most survivors, however, were asymptomatic. The study found an increase in the prevalence of cardiac conditions with age—the range was 3% to 24% in those who were between 30 and 39 years of age and 10% to 37% among older survivors (above the age of 40 years). Additional factors that influenced cardiac toxicity were the dose of anthracycline used in treatment and exposure to heart radiation. Radiation exposure greater than 1500 cGy along with anthracycline exposure (irrespective of dose) raised the odds of finding valvular effects.

This study underscores the importance of long-term screening in survivors to include monitoring their cardiac performance. Read more about the cardiotoxicity in cancer survivors and cardioooncology programs in cancer centers in this special issue of Evidence-Based Oncology.