title: Cardiovascular risk factors among long-term survivors of breast, prostate, colorectal, and gynecologic cancers: a gap in survivorship care?
abstract: OBJECTIVE
  Individuals diagnosed with high survival cancers will often die of cardiovascular disease (CVD) rather than a recurrence of their cancer, yet CVD risk factors may be overlooked during survivorship care. We assess the prevalence of CVD risk factors among long-term cancer survivors and compare results to survey data from the general population in the same geographic region. We also characterize how often at-risk survivors discuss CVD-related health behaviors with their health care providers.
  
  
  METHODS
  Survivors (n = 1,582) of breast, prostate, colorectal, and gynecologic cancers, 4-14 years after diagnosis, were recruited from two California cancer registries for a cross-sectional mail survey. We assessed CVD risk factors, including smoking, body mass index, physical inactivity, hypercholesterolemia, hypertension, and diabetes, as well as report of discussions with health care providers about diet, exercise, smoking, and lifestyle change assistance.
  
  
  RESULTS
  With the exception of current smoking, CVD risk factors were more common among survivors than the general adult population. Of survivors, 62.0 % were overweight or obese, 55.0 % reported hypertension, 20.7 % reported diabetes, 18.1 % were inactive, and 5.1 % were current smokers. Compared to white, non-Hispanic survivors, Hispanic (b = 0.37, p = 0.007) and African-American (b = 0.66, p < 0.0001), but not Asian, survivors reported significantly more risk factors. One in three survivors with one or more risk factors for CVD did not report a health promotion discussion with their health care providers.
  
  
  CONCLUSIONS
  CVD risk factors are common among long-term survivors, but many at-risk survivors may not discuss lifestyle prevention with their health care team. Primary care and oncology should work together to deliver optimal survivorship care that addresses CVD risk factors, as well as prevalent disease.
  
  
  CONCLUSIONS
  Cardiovascular disease may compromise cancer survivors' long-term health and well-being, yet cardiovascular risk factors may be overlooked during survivorship care. We document that CVD risk factors are common among cancers survivors, yet nearly a third of survivors do not report health promotion discussions with their medical teams. Survivors should be aware of their cardiovascular risk factors and initiate discussions with their medical teams about health promotion topics, if appropriate.
authors: Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. keweaver@wakehealth.edu
authors: Kathryn E
authors: KE
authors: Weaver
authors: Randi E
authors: RE
authors: Foraker
authors: Catherine M
authors: CM
authors: Alfano
authors: Julia H
authors: JH
authors: Rowland
authors: Neeraj K
authors: NK
authors: Arora
authors: Keith M
authors: KM
authors: Bellizzi
authors: Ann S
authors: AS
authors: Hamilton
authors: Ingrid
authors: I
authors: Oakley-Girvan
authors: Gretchen
authors: G
authors: Keel
authors: Noreen M
authors: NM
authors: Aziz
mesh_terms: D000359:Aftercare; D001943:Breast Neoplasms; D002140:California / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D015179:Colorectal Neoplasms; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D004198:Disease Susceptibility; D005260:Female; D005833:Genital Neoplasms, Female; D006301:Health Services Needs and Demand; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D009369:Neoplasms; D009765:Obesity / Q000453:epidemiology; D011471:Prostatic Neoplasms; D012307:Risk Factors; D057185:Sedentary Behavior; D012907:Smoking / Q000453:epidemiology; D017741:Survivors / Q000706:statistics & numerical data*