Cardiovascular disease is an important cause of morbidity and mortality in cancer survivors. The aim of this study was to investigate the modifiable cardiovascular disease risk factors and 10-year probability of the disease based on the Framingham risk score in cancer survivors, compared with the general population.
A total of 1,225 cancer survivors and 5,196 non-cancer controls who participated in the 2007–2013 Korea National Health and Nutrition Examination Surveys were enrolled. We assessed modifiable cardiovascular disease risk factors including smoking, body mass index, physical inactivity, high blood pressure, high cholesterol, and elevated blood glucose level. The 10-year probability of cardiovascular disease was determined by applying the Framingham cardiovascular disease risk equation among cancer survivors and non-cancer controls, ranging from 30 to 74 years old who had no overt cardiovascular diseases.
The proportion of subjects who had higher fasting glucose levels, hemoglobin A1c levels, systolic blood pressure, and low density lipoprotein cholesterol levels, and those who had lower high density lipoprotein cholesterol levels was significantly higher in the cancer survivors than in the non-cancer controls. The average 10-year probability of cardiovascular disease among the cancer survivors was higher than that in the non-cancer controls in both men and women. The average 10-year probability of cardiovascular disease in relation to the cancer type was significantly higher in patients with hepatic, colon, lung, breast, and gastric cancer.
Cancer survivors have a higher cardiovascular disease risk and 10-year probability of cardiovascular disease than non-cancer controls. Control of cardiovascular disease risk factors and implementation of a well-defined cardiovascular disease prevention program are needed for treating cancer survivors.
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This study aimed to evaluate an association between smoking, smoking cessation, and periodontal disease in Korean adults.
The data were collected from 8,336 participants, aged between 20 and 64 years, who participated in the fifth Korea National Health and Nutrition Examination (2010 and 2012). Smoking status was assessed using self-administered questionnaires. Periodontal disease was defined as a community periodontal index ≥3 points. Logistic regression analysis was used to evaluate an association between smoking, smoking cessation, and periodontal disease after adjusting for age, sex, education, monthly income, diabetes, obesity, alcohol intake, and frequency of tooth brushing.
The risk of periodontal disease was higher among current smokers (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.21-1.83) than never smokers. Among current smokers, the risk of periodontal disease was increased in smokers of ≥10 cigarettes/d, ≥20 years duration, and >10 pack-years compared with never smokers (P<0.05). Among former smokers, the risk of periodontal disease after 10 years since cessation declined to 0.56 (95% CI, 0.42-0.75) compared with current smokers and was indistinguishable statistically from never smokers.
Periodontal disease is significantly associated with smoking status in Korean adults.
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Health-related quality of life (HRQoL) is considered an important outcome measure in chronic diseases, in particular cardiovascular disease (CVD), which is known to be associated with impaired HRQoL. However, few studies have examined HRQoL in individuals at high risk of CVD.
Using the Fifth Korea National Health and Nutrition Examination Survey 2010-2012, we analyzed data from 10,307 adults aged ≥30 years. The study subjects were stratified into 3 groups on the basis of their Framingham risk score-a 10-year estimate of CVD risk: <10.0% (low risk), 10.0%-19.9% (moderate risk), and ≥20.0% (high risk). The EuroQol-5D (EQ-5D) was used to evaluate HRQoL.
A significantly higher proportion of high-risk subjects than low-risk participants had impaired HRQoL (defined as the lowest quartile of the EQ-5D index); this held true even after adjustment for confounding factors in multivariable logistic regression analysis (men: odds ratio [OR], 1.62; 95% confidence interval [CI], 1.24-2.11; women: OR, 1.46; 95% CI, 1.02-2.08). In terms of the 5 EQ-5D dimensions, a 10-year CVD risk ≥20.0% was significantly associated with self-reported problems of mobility in men (OR, 3.15; 95% CI, 2.02-4.90), and of mobility (OR, 1.56; 95% CI, 1.09-2.24), self-care (OR, 2.14; 95% CI, 1.09-4.22), and usual activity problems (OR, 1.80; 95% CI, 1.17-2.78) in women.
A high CVD risk is associated with impaired HRQoL. After adjustment for demographic and clinical factors, a 10-year CVD risk ≥20.0% is an independent predictor of impaired HRQoL in the general population; in particular, of mobility problems in men, and of mobility, self-care, and usual activity problems in women.
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Gastric cancer is the second most common cancer in Korea. Fatigue is a common symptom among cancer survivors. The aim of this study was to identify factors associated with fatigue in gastric cancer survivors.
Data were analyzed from 199 gastric cancer survivors who visited a cancer survivor outpatient clinic from July 2013 to June 2014. Patients were surveyed using a questionnaire containing a fatigue severity scale (FSS) and questions regarding associated symptoms. Participants were divided into fatigue (FSS) and non-fatigue groups based on FSS scores (≥4 and <4, respectively). Age, sex, weight, body mass index, cancer stage, pathology, surgery type, chemotherapy, radiotherapy, comorbid disease, family history of cancer, smoking, alcohol consumption, exercise, and laboratory results were investigated.
The fatigue and non-fatigue groups contained 42 and 157 survivors, respectively. Their mean age was 58 years, and the mean post-operative period was 6.58 years. Arthralgia (odds ratio [OR], 12.95; 95% confidence interval [CI], 3.21-52.34), dyspnea (OR, 10.54; 95% CI, 2.94-37.80), dyspepsia (OR, 8.26; 95% CI, 2.63-25.96), changed bowel habits (OR, 4.56; 95% CI, 1.09-19.11), anemia (OR, 3.18; 95% CI, 1.26-8.05), and regular exercise (OR, 0.31; 95% CI, 0.12-0.77) were significantly associated with fatigue in gastric cancer survivors, while weight, treatment, and depressive mood were not.
Arthralgia, dyspnea, dyspepsia, bowel habit change, anemia, and regular exercise are associated with fatigue in gastric cancer survivors.
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Prognosis in Palliative Care Study (PiPS) predictor models were developed in 2011 to estimate the survival of terminal cancer patients in the United Kingdom. The aim of this study was to validate the PiPS model for terminal cancer patients in Korea, and evaluate its value in clinical practice.
This study included 202 advanced cancer patients who were admitted to the cancer hospital's palliative care ward from November 2011 to February 2013. On admission, physicians recorded the PiPS-A, PiPS-B, and doctor's survival estimates in inpatients.
The median survival across PiPS-A categories was 9, 28, and 33 days, and the median survival across PiPS-B was 9.5, 27, and 43 days. The median actual survival was 25 days; overall accuracy between the PiPS-A, PiPS-B, doctor's estimates of survival, and actual survival was 52.0%, 49.5%, and 46.5%, respectively. The PiPS-A and PiPS-B groups for survival in 'days' showed a sensitivity of 48.4% and 64.1%, and specificity of 87.7%, and 77.5%, respectively. The PiPS-A and PiPS-B groups for survival in 'weeks' showed a sensitivity of 59.2%, and 44.7%, and specificity of 61.6%, and 64.7%, respectively. The PiPS-A and PiPS-B 'months' group showed a sensitivity of 37.1% and 37.1%, and specificity of 74.9% and 78.4%, respectively. The 'weeks' and 'months' groups showed significantly prolonged survival rates than 'days' group did in both PiPS-A and PiPS-B, by the Kaplan-Meier method.
The PiPS predictor models effectively predicted the survival ≥14 days in terminal cancer patients, and were superior to doctor's estimates.
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