# Association between Head and Neck Cancer and Increased Risk of Ischemic Heart Disease: A Retrospective Cohort Study Using National Population Data

## TL;DR

People with head and neck cancer face a higher long-term risk of heart disease, especially men and those with oral or nasal cancers.

## Contribution

This study reveals a long-term increased risk of ischemic heart disease in head and neck cancer patients using national population data.

## Key findings

- Head and neck cancer patients had a significantly higher IHD incidence (19.93 vs. 14.81) compared to non-HNC individuals.
- IHD risk surged 4 years after HNC diagnosis and remained elevated throughout the follow-up period.
- Men and patients with oral or sinonasal cancers showed a stronger association with IHD events.

## Abstract

This study elucidated an augmented incidence of ischemic heart disease (IHD) events in subjects diagnosed with head and neck cancer (HNC). The statistically significant escalation in the risk of IHD manifestation became apparent following a period of four years after the diagnosis of HNC, with a sustained high risk thereafter. Notably, an increased association with IHD events was observed among males with HNC, as well as in cases of malignancies localized to the oral cavity and sinonasal regions. Consequently, we advocate for the importance of using proactive strategies for early detection in the management of patients with HNC.

Although cancer and ischemic heart disease (IHD) frequently manifest in the same individual, the risk of IHD events in cancer, especially head and neck cancer (HNC), remains unclear. We aimed to examine the incidence and risk of IHD events in patients with HNC using a population-based cohort dataset in South Korea (2002–2013). Through rigorous propensity score matching, we compared data from 2816 individuals without HNC and 704 individuals with HNC. Key independent variables were matched between groups, and the Charlson Comorbidity Index was used to match comorbidities. The Kaplan–Meier method depicted the cumulative probability of IHD throughout the follow-up period for both the study and control groups. The overall IHD incidence was significantly higher (19.93) in patients with HNC than in those without HNC (14.81), signifying an augmented IHD risk in the HNC cohort. Subsequent temporal analysis revealed a significant surge in IHD risk commencing 4 years after HNC diagnosis and persisting throughout the follow-up period. Subgroup analysis revealed an increased IHD risk in men with HNC and patients with cancers affecting the oral and sinonasal regions. This retrospective cohort study provides valuable scientific insights into the nuanced relationship between HNC and IHD, underscoring the need for tailored monitoring protocols and specialized care for susceptible individuals.