ASPO Abstracts
An Assessment of Clinical and Behavioral Cardiovascular Disease Risk Factors in Black and White Breast Cancer Survivors
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
Purpose: Breast cancer (BC) survivors are at risk of developing cardiovascular disease (CVD). Some of this is due in part to
receipt of certain therapies (e.g. anthracyclines) and or existing conditions at the time of diagnosis. Limited data are available
regarding non-clinical risk factors that may contribute to CVD. Aims of this analysis were to explore the prevalence of and
racial differences CVD risk factors and identify clinical, demographic, and psychosocial predictors of CVD risk.
Methods: Newly diagnosed BC survivors were recruited from medical centers in Washington, DC and Detroit, MI. Medical
records and surveys captured clinical data (e.g. treatment type), lifestyle (e.g. smoking), psychosocial distress (e.g. anxiety)
and stressors (e.g. perceived discrimination). The prevalence of risk factors was assessed via descriptive statistics. Chi-
square tests were used to assess risk factors by race and between survivors who received anthracycline chemotherapy and
those who did not. Multinomial logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals
(CIs) for associations between predictors (e.g. race, insurance status) and risk factor score (0, 1-2, and ≥3).
Results: Among 358 women, 58.7% were Black and 64.0% were over the age of 50. Black women more commonly received
anthracycline chemotherapy (29.5% vs. 14.9%) and experienced depression (43.5% vs. 6.7%) than White survivors. Women
on anthracyclines more frequently experienced depression (48.5% vs. 29.2%) and had normal body mass index (36.0% vs.
22.2%) than women not on anthracyclines. Black survivors and survivors were more likely to report perceived healthcare
discrimination (44.0% vs. 16.3%). In the multinomial model, Black women (vs. White women, OR=2.79, 95% CI=1.22 to
6.37) and women with high school or less education (vs. more than high school, OR=5.75, 95% CI=1.26 to 26.36) were more
likely to have at 3 or more risk factors.
Conclusion: Survivors may require enhanced CVD surveillance prior to treatment and during survivorship. This is particularly
salient for Black women who had more risk factors and were more likely to have anthracycline chemotherapy. More research
is needed on the impact of stressors and distress on CVD disparities.
Keywords: Breast cancer, Cardiovascular disease risk, Disparities