UC Irvine

AIMS: To assess the burden of cardiometabolic factors and their associations with cardiovascular disease (CVD) among young adult (YA) cancer survivors (diagnosed between ages 19-39), while exploring ethnic disparities. METHODS: We conducted a retrospective cohort study of 8,943 YA cancer survivors diagnosed before December 31, 2021, with ≥2 years cancer survivorship, using University of California, Irvine (UCI) electronic medical records. Non-cancer participants were matched 1:1 based on sex and year of birth. Exposures: Cardiometabolic factors included type 2 diabetes (T2DM), hypertension, hyperlipidemia, and obesity. Main Outcomes: CVD outcomes encompassed stroke, myocardial infarction (MI), and congestive heart failure (CHF). Generalized linear mixed models with binary outcome were conducted to assess the associations of interest. RESULTS: The mean age at cancer diagnosis was 29.2 years (SD: 5.90), with 57.39% female participants. Cardiometabolic factors were more prevalent in cancer survivors compared to non-cancer participants, with racial/ethnic disparities observed. Significant associations between cardiometabolic factors and CVD were identified; cancer survivors with T2DM had higher odds of MI (adjusted odds ratio [aOR]: 6.99; 95% CI: 3.45-14.19) and CHF (aOR: 12.304; 95% CI: 7.23-20.91). Hypertension was strongly associated with CHF (aOR: 20.48;95%CI: 11.79-35.57). CONCLUSIONS: Cardiometabolic factors independently contribute to elevated CVD risk in YA cancer survivors, beyond the effects of cancer treatment alone. These findings underscore the need for integrated cardiometabolic risk assessment and prevention strategies in survivorship care, including early screening, lifestyle interventions, and targeted management approaches.