Abstract IA28: Disparities in cardiovascular disease incidence in breast cancer survivors

Abstract Many breast cancer therapies have adverse effects on the cardiovascular health of patients. Breast cancer patients who are members of racial/ethnic minority and disadvantaged socioeconomic groups suffer disproportionately from cardiotoxicity during and after cancer treatment, leading to disparities in overall survival. These disparities may exist, in part, because of inequality in the management of pre-existing cardiovascular diseases and its risk factors such as hypertension and diabetes. Shared lifestyle risk factors for breast cancer and cardiovascular diseases, including obesity, poorer diet, and lack of physical activity may contribute to disparate outcomes in cardiotoxicity. In addition, patients of racial/ethnic minority and disadvantaged socioeconomic groups may have limited access to cardio-oncology care due to lack of insurance coverage and longer geographic distance from their health care provider. Patients living in disadvantaged neighborhoods may lack healthy food options and exercise facilities, thus are unable to follow a heathier lifestyle. We present evidence from prior studies on these potential mechanisms of disparities in cardiotoxicity and accompanying gaps in research. Finally, we introduce our ongoing Pathways Heart Study (R01 CA21 4057, mPI: Kwan, Greenlee), a large population-based study of nearly 15,000 breast cancer survivors and 75,000 noncancer controls who are members of Kaiser Permanente Northern California, which is an extension of the Pathways Study of 4,505 breast cancer survivors (U01 CA19 5565, mPI: Kushi, Ambrosone). Our study provides a unique opportunity to better understand the individual and health care system level contributors to risk of cardiotoxic outcomes. Citation Format: Zaixing Shi, Heather Greenlee, Romain S. Neugebauer, Carlos Iribarren, Mai N. Nguyen-huynh, Jamal S. Rana, Dawn L. Hershman, Lawrence H. Kushi, Marilyn L. Kwan. Disparities in cardiovascular disease incidence in breast cancer survivors [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr IA28.