The association between Life's Essential 8 and all-cause, cancer and non-cancer mortality in US Cancer Survivors: A retrospective cohort study of NHANES

Jan 11, 2024Preventive medicine

How Life's Essential 8 relates to overall, cancer, and non-cancer death rates in US cancer survivors

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Abstract

In a 15-year follow-up of 1818 cancer survivors, 2548 deaths were recorded.

High cardiovascular health (CVH) is associated with lower risks of all-cause, cancer-specific, and non-cancer mortality compared to low CVH.
Cumulative mortality rates increased significantly during follow-up, particularly in the low CVH group.
Subgroup analyses indicated significant interactions between LE8 and age or Poverty Income Ratio (PIR) regarding all-cause mortality.
Significant interactions were also found between LE8 and PIR for cancer-specific and non-cancer mortality risks.

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OBJECTIVE: To investigate Life's Essential 8 (LE8), a measure of cardiovascular health (CVH), associations with mortality outcomes in cancer survivors.

METHODS: A prospective cohort study included 1818 cancer survivors aged ≥20 years (weighted population: 13,204,583) from National Health and Nutrition Examination Survey (NHANES) 2005-2018. Linked to mortality data through 2019, LE8 data were gathered through self-reports and lab tests. An LE8 score of 80-100 is considered high CVH, 60-79 is moderate CVH, and 0-59 is low CVH. Multivariable Cox proportional hazards regression models were employed to evaluate the associations between LE8 and all-cause, cancer-specific and non-cancer mortality. Subsequently, subgroup analyses were conducted to assess the relationship between LE8 and mortality rates across various subgroups.

RESULTS: At baseline, there were 1818 cancer survivors. In a 15-year follow-up, 2548 deaths occurred: 601 from cancer, 647 from heart disease, and 1300 from other causes. Multivariable models showed high CVH associated with lower hazard ratios for all-cause, cancer-specific and non-cancer mortality vs. low CVH. Cumulative mortality rates increased during follow-up, more so in the low CVH group. Subgroup analysis revealed significant LE8 interactions with age or Poverty Income Ratio (PIR) for all-cause mortality. Additionally, significant interactions between LE8 and PIR were identified for cancer-specific and non-cancer mortality risks (P for interaction <0.05).

CONCLUSION: Among U.S. cancer survivors, higher CVH is independently linked to lower all-cause, cancer-specific, and non-cancer mortality risks. The new CVH definition shows promise as a primary prevention strategy to reduce mortality rates in U.S. cancer survivors.

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The association between Life's Essential 8 and all-cause, cancer and non-cancer mortality in US Cancer Survivors: A retrospective cohort study of NHANES

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