Cardiovascular disease risks among head and neck cancer survivors in a large, population-based cohort study.

6051 Background: Over 63,000 Americans develop head and neck cancer (HNC) yearly. The 5-year survival rate for HNC patients is 40-90%. HNC shares risk factors to cardiovascular disease (CVD), such as age > 60 years, male sex, low fruit and vegetable intake, tobacco and alcohol use. Our study was to investigate cardiovascular complications and risk factors for CVD among HNC survivors. Methods: A total of 1,901 HNC patients diagnosed between 1997 and 2012, and 7,796 age and sex matched individuals from the general population were identified. CVD diagnoses were identified in electronic medical records: statewide ambulatory surgery and inpatient visit databases linked to the Utah Population Database. Multivariate Cox proportional hazard models were used to calculate hazard ratios (HR) for cardiovascular outcomes at 0-2 years, 2-5 years and 5+ years after HNC diagnosis. Results: Within the first 2 years after cancer diagnosis, HNC survivors had higher risks of developing CVD than matched comparison individuals, such as heart valve disease (HR 3.33, 95% 2.60-4.28), cardiomyopathy(HR3.21, 95% 2.04-5.03), systolic heart failure (HR 3.90, 95% 3.10-4.89), conduction disorders (HR 5.73, 95% 4.02-8.16), acute myocardial infarction (HR 3.11, 95% 2.08-4.65), coronary atherosclerosis (HR 3.42, 95% 2.90-4.03) and cardiac dysrhythmias (HR 4.26, 95% 3.68-4.93). The risks persisted even 5 years after cancer diagnosis. More baseline comorbidities(HR 1.27, 95%1.01-1.58), late stage of disease (HR 2.20, 95% 1.64-2.96), age > = 65 years old (HR 1.56, 95% 1.27-1.92), radiation therapy (HR 1.33, 95% 1.07-1.65) and chemotherapy (HR 1.72, 95% 1.39-2.13) were associated with increased CVD risk. Baseline comorbidities such as diabetes (HR 3.68, 95% 2.82-4.80), hyperlipidemia (HR 4.59, 95% 3.62-5.82), hypertension (HR 2.90, 95% 1.60-2.52) and chronic kidney disease (HR 5.14, 95% 4.19-6.30) were associated with increased CVD risk. Conclusions: Compared to the general population, HNC survivors have higher risk of developing CVD. Older age, late stage of cancer, comorbidities, radiation therapy and chemotherapy were risk factors. Close CVD monitoring and preventive treatments should be considered in this population.