Ethnic differences in cardiovascular morbidity and mortality among breast cancer patients

Background

Cardiovascular disease (CVD) is of increasing concern among breast cancer survivors. However, evidence on ethnic differences in CVD among women with breast cancer is sparse. We assessed ethnic differences in cardiovascular morbidity and mortality among breast cancer patients in the Netherlands.

Methods

A nationwide register-based cohort study comprising all women with a first admission for breast cancer (n = 127,714) between 1996 and 2010 in the Netherlands was conducted. Differences in CVD admission, CVD mortality and overall CVD event, which comprised a CVD admission and/or CVD mortality, between the largest ethnic minority groups (Surinamese, Moroccan, Turkish, Antillean, and Indonesian) and the Dutch general population (henceforth, Dutch) were investigated using Cox proportional hazard models.

Results

The incidence of cardiovascular outcomes varied by ethnic group. The incidence of a cardiovascular event, which comprised a CVD admission and/or CVD mortality, was significantly higher for women with breast cancer from Suriname (HR = 1.46; 95% CI 1.29–1.64) and Turkey (HR = 1.25; 95% CI 1.03–1.51), compared with Dutch women with breast cancer. In contrast, Indonesian women with breast cancer had a significantly lower risk (HR = 0.88; 95% CI 0.81–0.96) of a cardiovascular event compared with Dutch women with breast cancer. There were no significantly differences between Moroccan and Antillean women, and Dutch women with breast cancer.

Conclusions

Our findings suggest that Surinamese and Turkish women with breast cancer are disadvantaged in terms of cardiovascular outcomes compared with Dutch women with breast cancer. More work is needed to unravel the potential factors contributing to these differences.

Key messages:

The risk of CVD related outcomes among breast cancer patients vary by ethnicity.

Surinamese and Turkey breast cancer patients experienced a higher risk, whereas Indonesian patients had a slightly lower risk of CVD event compared with their Dutch counterparts.