Disparities in cardiovascular disease burden among Black and Hispanic survivors of adolescent and young adult (AYA) cancer

Background: Despite significant improvements in long-term survival outcomes for adolescents and young adults (AYAs) with cancer, common treatment regimens often pose substantial risks to the cardiovascular health of this survivor population. Differences in cardiovascular events by race/ethnicity and genetic ancestry within this at risk population remain unclear. Methods: In this study, we investigated adverse cardiovascular outcomes in a diverse population of AYA cancer survivors (n = 346) treated at MD Anderson Cancer Center for Hodgkin lymphoma and sarcoma. Analysis was conducted by self-identified race/ethnicity and by genetic ancestry. Results: Black and Hispanic survivors demonstrated the greatest burden of poor cardiovascular health, with 54.5% and 34.2% respectively, experiencing a cardiovascular disease diagnosis compared to only 22.9% for White survivors (p < 0.001). This finding remained when hypertension and hyperlipidemia were excluded from the analysis (27.3%, 15.1%, and 7.5% (p = 0.001), respectively). African ancestry was associated with a 5-fold increased risk of cardiovascular disease (OR: 5.48, 95% CI: 2.04–14.7, p < 0.001), while European ancestry displayed a protective effect (OR: 0.15, 95% CI: 0.07–0.32, p < 0.001). Conclusions: This study reveals that important disparities in cardiovascular health outcomes exist according to self-identified race/ethnicity and genetic ancestry among survivors of AYA cancer. These findings emphasize the need for tailored monitoring and intervention strategies that account for disparities in cardiovascular outcomes among survivors of AYA cancer.