Having co-morbid cardiovascular disease at time of cancer diagnosis: already one step behind when it comes to HRQoL?

Figures & data

Table 1. Socio-demographics and clinical characteristics stratified by CVD status.

	Total (n = 5930)	CVD (n = 1441)	No CVD (n = 4489)
Socio-demographics
Gender (m)	3421 (57.7)	851 (73.9)	2544 (54.7)*
Median age at diagnosis	61 (18–88)	68 (34–88)	59 (18–88)*
Married/co-habiting	4584 (78.2)	890 (78.8)	3603 (78.2)
Educational level
Low	958 (16.4)	242 (21.4)	695 (15.2)*
Intermediate	3561 (61.0)	674 (59.5)	2799 (61.1)
High	1322 (22.6)	217 (19.2)	1085 (23.7)
Clinical characteristics
Cancer stage^a
I	1635 (30.8)	291 (28.3)	1289 (31.0)
II	1851 (34.9)	372 (36.1)	1454 (35.0)
III	1262 (23.8)	246 (23.9)	991 (23.8)
IV	554 (10.4)	121 (11.7)	425 (10.2)
Treatment
Surgery	3622 (61.1)	613 (53.2)	2910 (62.6)*
Systemic therapy	2013 (33.9)	349 (30.3)	1627 (35.0)*
Radiation	1740 (29.3)	309 (26.8)	1392 (29.9)*
Hormone treatment	319 (5.4)	103 (8.9)	212 (4.6)*
Time since diagnosis
Median years (sd)	4.6 (3.1)	3.2 (2.4)	4.7 (3.2)*
0–1 year	603 (10.2)	113 (9.8)	441 (9.5)*
2–5 years	3451 (58.4)	779 (67.6)	2628 (56.8)
6–10 years	1629 (27.6)	249 (21.6)	1351 (29.2)
≥11 years	226 (3.8)	11 (1.0)	207 (4.5)
Co-morbidities
0	2620 (44.2)	396 (34.4)	2156 (46.4)*
1	1740 (29.3)	359 (31.2)	1345 (28.9)
≥2	1570 (26.5)	397 (34.5)	1147 (24.7)
Malignancy
Colorectal	2281 (38.5)	454 (20.2)	1793 (79.8)
Thyroid	280 (4.7)	15 (5.4)	261 (94.6)
Prostate	1054 (17.8)	291 (27.8)	756 (71.7)
Endometrium	177 (3.0)	28 (20.0)	112 (80.0)
Ovarian	389 (6.6)	46 (12.5)	322 (87.5)
Melanoma	212 (3.6)	20 (9.7)	187 (90.3)
Non-Hodgkin lymphoma	874 (14.7)	175 (20.3)	688 (79.7)
Hodgkin lymphoma	194 (3.3)	12 (6.3)	179 (93.7)
CLL	242 (4.1)	63 (26.0)	177 (73.8)
MM	227 (3.8)	48 (21.7)	173 (78.3)

Socio-demographic and clinical characteristics in numbers (percentages) and age in median years (range). *p < .05; ^aStage was missing for 10.6% as for CLL and MM stage was undetermined/unregistered.

Figure 1. Differences in HRQoL among those with and without CVD at cancer diagnosis for all survivors combined. Note: *p < .05, **p < .01. a: trivial; b: small; c: medium clinically important difference. QoL: global QoL; PF: physical functioning; RF: role functioning; EF: emotional functioning; CF: cognitive functioning; SF: social functioning; FA: fatigue; DY: dyspnea. Controlling for age, gender, marital status, education, stage, time since diagnosis, and co-morbidities.

Table 2. Unstandardized beta’s of linear regression analyses associating co-morbid CVD at cancer diagnosis with HRQoL scales specified for each malignancy.

	QoL	FP	RF	EF	CF	SF	FA	DY
Colorectal	−3.54*^a	−6.89**^b	−3.51*^a	−1.71	−1.69	−2.01	2.63*^a	5.75**^b
Thyroid	−4.23	−7.95	−6.48	−3.88	7.24	−8.51	3.48	11.05
Prostate	−4.67**^b	−6.77**^b	−7.20**^b	−1.46	−1.75	−4.18**^a	5.05**^b	8.26**^b
Endometrium	−4.34	−0.67	5.11	−5.72	−0.07	−1.74	2.62	1.91
Ovarian	−4.35	0.31	−6.78	−4.25	2.67	−0.88	2.57	8.50*^b
Melanoma	−4.44	0.31	−4.22	0.13	−8.46*^b	−0.18	1.90	−0.77
Non-Hodgkin lymphoma	−3.71*^a	−6.29**^b	−5.94*^a	−1.00	−1.88	−1.66	4.11	11.58**^c
Hodgkin lymphoma	1.73	2.27	−4.14	−0.10	8.96	−4.66	−2.56	−7.91
CLL	−9.03**^b	−13.80**^b	−10.58**^b	−7.58*^b	−0.22	−9.24**^b	10.42*^b	7.02
MM	−2.16	−7.34	−8.14	−3.79	0.20	−1.91	2.99	2.86

QoL: global QoL; PF: physical functioning; RF: role functioning; EF: emotional functioning; CF: cognitive functioning; SF: social functioning; FA: fatigue; DY: dyspnea. Higher score on the global QoL and functional scales means better functioning and HRQoL, whereas a higher score on the symptom scales fatigue and dyspnea means more complaints; *p < .05, **p < .01. ^atrivial; ^bsmall, ^cmedium clinically important difference. Controlling for age, gender, marital status, education, stage, time since diagnosis, and co-morbidities.