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Breast cancer is the most common cancer in women, and its prevalence is steadily increasing
worldwide.
The incidence of breast cancer in South Korea continues to rise
in all ages.
The main characteristics of breast cancer in Korea are that the incidence rate is higher among young women aged 40~49, the proportion of premenopausal women increases, and the survival rate is higher than that of other countries
.
Improved cancer screening and advanced cancer treatment will further increase the number of
breast cancer survivors.
While endocrine therapy is an effective treatment for breast cancer, its anti-estrogenic effects have been linked to
an increased risk of cardiovascular disease and type 2 diabetes.
Recently, JAHA, an authoritative journal in the field of cardiovascular diseases, published a research article that aims to investigate the relationship between endocrine therapy and cardiovascular disease and type 2 diabetes risk in breast cancer survivors in Korea, taking into account the differences
in different age groups.
A total of 133171 breast cancer patients over the age of 20 were included in the Korean
National Health Insurance database.
Endocrine therapy is considered a time-varying exposure, and patients are divided into no use, selective estrogen receptor modulators, aromatase inhibitors, and both
.
Time-dependent Cox regression models were used to estimate hazard ratios (HRs) and 95% CIs
.
Age at diagnosis, socioeconomic status, histologic type, other treatments, and comorbidities were adjusted
in the model.
Patients with selective estrogen receptor modulators had a higher risk of stroke (HR 1.
20 [95% CI 1.
04 to 1.
40]) and venous thromboembolism (HR 1.
47 [95% CI 1.
13 to 1.
90]) compared with those who did not use estrogen receptor modulators, while those with aromatase inhibitors had a higher risk of coronary heart disease (HR 1.
22 [95% CI 1.
06 to 1.
41]).
。 The risk of type 2 diabetes was associated with
users of selective estrogen receptor modulators (HR 1.
13 [95% CI 1.
05 to 1.
21]), aromatase inhibitor users (HR 1.
14 [95% CI 1.
05 to 1.
23]), and both users (HR 1.
24 [95% CI 1.
10 to 1.
39]).
In particular, in young or premenopausal patients, the risk of cardiovascular disease is higher
.
It can be seen that among breast cancer survivors in Korea, endocrine therapy is associated
with a high risk of cardiovascular disease and type 2 diabetes.
In young and elderly patients, cancer comorbidities
following endocrine therapy need to be monitored.
Original source:
Ji‐Eun Kim,et al.
Effects of Endocrine Therapy on Cardiovascular Diseases and Type 2 Diabetes Among Breast Cancer Survivors: The National Health Insurance Service Database of Korea.
JAHA.
2022.
https:// www.
ahajournals.
org/doi/10.
1161/JAHA.
122.
026743