Prevalence of cardiovascular, kidney, and metabolic disease in breast and lung cancer patients in the United States.

Abstract

e23081 Background: Cardiovascular, kidney, and metabolic (CKM) diseases impact cancer treatment tolerance and outcomes. We sought to detail CKM comorbidity burden at the time of breast cancer and lung cancer diagnosis among a representative sample of older adults in the United States. Methods: Using the SEER–Medicare linked database, we identified adults ≥ 65 years diagnosed with breast or lung cancer between 2010 and 2019 with Medicare A and B coverage in the year prior to cancer diagnosis. CKM conditions were identified using the CMS Chronic Conditions Data Warehouse, defined from ICD-9 and ICD-10 diagnosis codes from Medicare claims. CKM comorbidity burden was compared by age, sex, race, and Medicaid dual eligibility. Results: Among 129,047 lung cancer patients (mean age 74.7, 50.2% women, 10.2% black, 5.1% Asian), individual CKM conditions were highly prevalent, including ischemic heart disease (39.1%), heart failure (21.5%), diabetes (29.6%), and chronic kidney disease (23.2%). Among 279,418 breast cancer patients (mean age 73.2, 99.1% women, 11.3% black, 4.6% Asian), ischemic heart disease (27.4%), heart failure (14.7%), diabetes (26.1%), and chronic kidney disease (12.5%) were also common. Overall, CKM burden was greater in lung versus breast cancer, with higher prevalence of ≥1 (68.3% vs 61.2%), ≥2 (52.6% vs 42.0%), and ≥3 CKM comorbidities (38.1% vs 26.1%), and higher mean Charlson comorbidity index (2.03±2.04 vs 0.95±1.44). In both cancer types, CKM burden increased with age, with notable racial and socioeconomic differences. Among breast cancer patients, multi-comorbidity (≥3 CKM conditions) varied by self-identified race (21% of Asian, 35% of black, and 25% of white patients), with similar findings in lung cancer. Medicaid dual-eligible patients had a higher prevalence of ≥3 CKM comorbidities than non-dual-eligible patients in breast (43.7% vs 22.3%) and lung cancer (48.6% vs 35.0%). Conclusions: CKM comorbidity burden is highly prevalent among older adults with breast and lung cancer, with disparities by race and Medicaid dual-eligibility. Early targeted strategies addressing cardiometabolic disease alongside cancer care at diagnosis may help improve patient outcomes.