Abstract B16: Comparing heart age among Alabama residents with and without a history of cancer
Authors: Bui Jacqueline , Raju Dheeraj , Landier Wendy , Kenzik Kelly , Scarabelli Tiziano , Meneses Karen 
Published: March 2017

Background: The US five-year cancer survival rate is approaching 67%, and there are 25,000 cancer survivors currently living in Alabama. The survival increase is likely attributable to earlier diagnosis and treatment advancements. However, in addition to modifiable and non-modifiable risk factors, cancer treatment-related cardiotoxicity may contribute to cancer survivors' potential increased risk of developing cardiovascular disease. Cardiovascular disease risk can be estimated using heart age, which is the predicted age of the vascular system. Excess heart age is the difference between heart age and chronological age. In a recent study, Yang et al. (2015) demonstrated that Alabama residents have an average excess heart age of 8.9 years, ranking among the worst five states for cardiovascular health. The purpose of this abstract is to evaluate heart age of cancer survivors in Alabama, who may be at increased risk for cardiovascular disease at baseline, and compare to Alabama residents without a history of cancer.

Methods: A secondary data analysis was conducted using the Behavioral Risk Factor Surveillance System dataset. Data from 2011 and 2013 on participants between 30 and 74 years of age were retrieved from the Alabama Department of Public Health. Heart age was used to explore cardiovascular risk. Heart age was calucated using age, smoking status, diabetes status, anti-hypertensive use, height, and weight. Participants were excluded if they self-reported history of coronary heart disease or stroke, were pregnant, or had missing heart age variables. Descriptive statistics of cancer survivors (n = 1,400) and non-cancer residents (n = 6,753) were conducted. Sample t-test and Mann Whitney U analyses were used to compare excess heart age among residents who are and are not cancer survivors. Significance was set at 0.05. SAS 9.4, SUDAAN 11.0.1, and RStudio 3.2.3 were used to conduct statistical analyses.

Results: Majority of cancer survivors and non-cancer residents were female (68% vs 65%), married (61% vs 56%), and overweight or obese (68% vs 72%). Cancer survivors and non-cancer residents had similar reports of unemployment (34% vs 38%), high school degree or less (42% vs 42%), and annual household income of less than $35,000 (37% vs 39%). Cancer survivors and non-cancer residents reported a race/ethnicity of Hispanic (1% vs 1%), non-Hispanic black (12% vs 29%), and non-Hispanic white (85% vs 67%). Cancer survivors and residents without a history of cancer had a mean chronological age of 61 years (SD 9.88) and 53 years (SD 11.76) and mean heart age of 74 years (SD 20.26) and 64 years (SD 20.31), respectively. Excess heart age was significantly higher in cancer survivors (14 years) than those without cancer (11 years), p &lt; 0.01. The effect size (Cohen's D = 0.20) was small.

Conclusion: Among the sample of 8,153 Alabama residents, cancer survivors have significantly higher heart age score, suggestive of greater risk for developing cardiovascular disease than residents with no history of cancer. Additional analyses will include exploring decision tree and logistic regression models to predict cancer diagnosis. Disparities in race, age, socioeconomic status, and geographic locations will be explored. Future research includes developing interventions to reduce the cardiovascular risk among cancer survivors.

Acknowledgments: This study was approved by the University of Alabama at Birmingham Institutional Review Board. The first author is supported by funding from the Robert Wood Johnson Foundation, Gladys Colvin Endowed Scholarship, and Susan G. Komen Graduate Trainee in Disparities Research Scholarship.

Citation Format: Jacqueline Bui, Dheeraj Raju, Wendy Landier, Kelly Kenzik, Tiziano Scarabelli, Karen Meneses. Comparing heart age among Alabama residents with and without a history of cancer. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B16.