Health Equity in Cardio-oncology: Investigating Mechanistic Causes Behind Adverse Cardiovascular and Cancer Health

The goal of this review is to highlight the current literature on inequities as it relates to cardiovascular disease outcomes among cancer patients to identify the potential multilevel biologic and societal causes and potential solutions.

Mounting data suggest gaps in the incidence and outcomes of cardiovascular events among patients with cancer. The factors behind the disparities appear to involve various social, biologic, and societal causes. This is exemplified by breast cancer, wherein mortality is nearly 40% higher rates among Black women. Emerging data suggest that challenges in access, social determinants, heterogeneous genetic factors, and more aggressive oncologic disease states requiring more intense and often cardiotoxic therapies may critically contribute to the observed disparities in long-term clinical outcomes. In this report, we outline many of the established and emerging drivers of these disparities in cardiotoxic risk, risk factor control, and outcomes.

Cardiovascular disparities among cancer patients are an increasingly important issue. Understanding the societal and biologic contributors may allow the mitigation of cardio-oncology disparities as we advance into the twenty-first century.