Cardiovascular Disease Risk Among Older Asian, Native Hawaiian, Pacific Islanders Lung Cancer Survivors

Abstract

Background

There may be heterogeneity in lung cancer-related outcomes for individuals who are Asian, Native Hawaiian, and Pacific Islanders (ANHPI).

Objectives

The aims of this study were to investigate possible disparities in cardiovascular disease (CVD) risk between ANHPI and Non-Hispanic White (NHW) lung cancer survivors and evaluate potential CVD risk factors.

Methods

A total of 3920 ANHPI and 11,760 NHW lung cancer patients aged 66 years and older were identified from the Surveillance, Epidemiology, and End Results (SEER)-Medicare registry from 1999 to 2017. Cox proportional hazards models were used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for incident CVD, comparing ANHPI lung cancer patients and their race/ethnicity subgroups to NHW lung cancer patients.

Results

Compared to NHW lung cancer patients, ANHPI lung cancer patients had a lower risk of developing heart failure (HR, 0.64, 95% CI, 0.53–0.76) and ischemic heart disease (HR, 0.76, 95% CI, 0.60–0.95). Additionally, compared to Chinese lung cancer patients, Pacific Islander, South Asian, and Southeast Asian lung cancer patients had a higher risk of heart failure.

Conclusion

While ANHPI lung cancer patients had lower risks of heart failure and ischemic heart disease than NHW lung cancer patients, heterogeneity in risk was observed among ANHPI subgroups. Further research is needed to investigate the reasons for the higher risk of several CVDs among Pacific Islander, South Asian, and Southeast Asian lung cancer patients.