Increased risk of non-hematological cancer in young patients with aortic stenosis: a retrospective cohort study

Walid Saliba, Tamir Bental, Yaron Shapira, Shmuel Schwartzenberg, Alex Sagie, Moti Vaturi, Salim Adawi, Alexander Fuks, Ami Aronheim, Avinoam Shiran*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: We have previously reported an increased risk for non-hematological malignancies in young patients with moderate or severe aortic stenosis (AS). These findings were the result of a post-hoc analysis from a large echocardiography database and needed verification. Our aim was to determine, using a different study population, whether young patients with AS are at increased risk for cancer. Methods: A large echocardiographic database was used to identify patients (age ≥ 20 years) with moderate or severe AS (study group) and patients without aortic stenosis (comparative group). The new occurrence of non-hematological malignancies was determined after the index date (first echo with moderate or severe AS or first recorded echo in the control group). Results: The final study group included 7013 patients with AS and 98,884 without AS. During a median follow-up of 6.9 years (3.0–11.1) there were 10,705 new cases of non-hematological cancer. The crude incidence rate of cancer was higher in AS compared to non-AS patients (22.3 vs. 13.7 per 1000 patient-year, crude HR 1.58 (95%CI 1.46–1.71). After adjustment for relevant covariates, there was no difference between groups (HR 0.93, 95% CI 0.86–1.01). Only patients in the lowest age quartile (20–49.7 years), had an increased adjusted risk of cancer (HR 1.91, 95%CI 1.08–3.39). The HR for the risk of cancer associated with AS was inversely proportional to age (P < 0.001 for the interaction between AS and age). Conclusions: Young patients with moderate or severe AS may have an increased risk for cancer. Cancer surveillance should be considered for young patients with AS.

Original languageEnglish
Article number37
JournalCardio-Oncology
Volume7
Issue number1
DOIs
StatePublished - Dec 2021
Externally publishedYes

Keywords

  • Age
  • Aortic stenosis
  • Cancer
  • Risk

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