Abstract 902: Contributions of cancer treatment, comorbidities and obesity to aging-related diseases risks in B-cell non-Hodgkin's lymphoma survivors
Authors: Ocier Krista , Abdelaziz Sarah , Kim Seungmin , Rowe Kerry , Snyder John , Deshmukh Vikrant , Newman Michael , Fraser Alison , Smith Ken , Porucznik Christina A. , Shoaf Kimberley , Stanford Joseph B. , Lee Catherine J. , Hashibe Mia 
Published: July 2021

Abstract
Introduction. Prior studies on risk factors for aging-related diseases among B-cell non-Hodgkin's lymphoma (B-NHL) survivors are limited. In order to improve timely management and prevention of early-onset aging-related diseases among B-NHL survivors, the contribution of specific risk factors such as cancer treatment, preexisting comorbidities, obesity, and smoking is important to understand. Therefore, the purpose of this study is to calculate population attributable fractions (PAF) of risk factors for aging-related disease risks among B-NHL survivors in Utah.
Methods. B-NHL survivors were identified in the Utah Cancer Registry (n = 2,146). Population attributable fraction (PAF) was calculated as P x (multi-adjusted relative risk - 1)/multi-adjusted relative risk, where P is the proportion of B-NHL survivors who were exposed to a specific risk factor, to estimate the burden of these risk factors for aging-related diseases ≥5 years after cancer diagnosis. Aging-related disease outcomes included heart disease, congestive heart failure, chronic obstructive pulmonary disease (COPD), pneumonia, chronic kidney disease, and acute renal failure.
Results. More than half of B-NHL survivors were men (54.5%) and were diagnosed &lt;65 years old (60.1%). The majority of participants were nonsmokers (88.7%) and had no family history of lymphoma (94.9%). Approximately 42.6% of B-NHL survivors were overweight and 21.5% were obese at baseline. Cancer treatment contributed to 11.3% of heart disease, 11.2% of COPD, and 14.1% of chronic kidney disease. Charlson Comorbidity Index (CCI) at baseline contributed to all six diseases with a range of 9.9% of heart disease to 26.5% of chronic kidney disease. The most common comorbidities at baseline included chronic pulmonary disease (32.6%), diabetes without complications (12.5%), and myocardial infarction (9.2%) among B-NHL patients upon cancer diagnosis. High BMI at baseline contributed to 18.4% of congestive heart failure, 7.9% of pneumonia, and 12.8% of acute renal failure, while smoking contributed to these diseases with a range of 0.3% of pneumonia to 6.4% of acute renal failure.
Conclusion. Cancer treatment contributed more to risk of chronic diseases such as heart disease, COPD, and chronic kidney disease. In terms of more acute conditions, high BMI at baseline contributed more to congestive heart failure and pneumonia than cancer treatment. Smoking at baseline, however, was not a major risk factor of these aging-related diseases in this B-NHL survivor cohort. Overall, baseline comorbidities consistently demonstrated high attributable risks across all six diseases, suggesting a need for prevention and management of preexisting comorbidities before and after cancer diagnosis.
Citation Format: Krista Ocier, Sarah Abdelaziz, Seungmin Kim, Kerry Rowe, John Snyder, Vikrant Deshmukh, Michael Newman, Alison Fraser, Ken Smith, Christina A. Porucznik, Kimberley Shoaf, Joseph B. Stanford, Catherine J. Lee, Mia Hashibe. Contributions of cancer treatment, comorbidities and obesity to aging-related diseases risks in B-cell non-Hodgkin's lymphoma survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 902.