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Introduction <p>Cardiovascular-Kidney-Metabolic (CKM) syndrome is common among cancer survivors, largely driven by overlapping risk factors and therapy-induced toxicities; however, its contribution to long-term mortality has not been clarified.</p> Methods <p>From the 1999–2018 National Health and Nutrition Examination Survey (NHANES) cycles, 2,274 cancer survivors with CKM syndrome stages 1–4 were included. Associations between CKM syndrome staging and long-term mortality were analyzed using weighted Cox regression, and further explored through subgroup and sensitivity analyses.</p> Results <p>During a median follow-up of 10.2 years, 854 deaths occurred (277 cancer-related, 224 cardiovascular). Higher CKM stages were associated with increased all-cause and cardiovascular mortality, but not cancer-specific mortality. Adjusted HRs (95% CIs) for all-cause mortality were 1.215 (95% CI: 0.757–1.950) for stage 2, 1.772 (95% CI: 1.089–2.885) for stage 3, and 2.560 (95% CI: 1.597–4.103) for stage 4; for cardiovascular mortality, HRs were 1.406 (95% CI: 0.582–3.393), 2.910 (95% CI: 1.108–7.644), and 5.960 (95% CI: 2.158–16.458).</p> Conclusion <p>Progression of CKM syndrome was linked to increased all-cause and cardiovascular mortality among cancer survivors, underscoring the need for early recognition and intervention.</p> Trial registration <p>Not applicable.</p>

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Associations of cardiovascular–kidney–metabolic syndrome stages with long-term mortality among US cancer survivors: a prospective cohort study

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  • 出版模式：

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  • 发表日期：

    2026年2月11日

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  • Yangyang Zheng,
  • Ting Li,
  • Jinghai Song

摘要

Introduction

Cardiovascular-Kidney-Metabolic (CKM) syndrome is common among cancer survivors, largely driven by overlapping risk factors and therapy-induced toxicities; however, its contribution to long-term mortality has not been clarified.

Methods

From the 1999–2018 National Health and Nutrition Examination Survey (NHANES) cycles, 2,274 cancer survivors with CKM syndrome stages 1–4 were included. Associations between CKM syndrome staging and long-term mortality were analyzed using weighted Cox regression, and further explored through subgroup and sensitivity analyses.

Results

During a median follow-up of 10.2 years, 854 deaths occurred (277 cancer-related, 224 cardiovascular). Higher CKM stages were associated with increased all-cause and cardiovascular mortality, but not cancer-specific mortality. Adjusted HRs (95% CIs) for all-cause mortality were 1.215 (95% CI: 0.757–1.950) for stage 2, 1.772 (95% CI: 1.089–2.885) for stage 3, and 2.560 (95% CI: 1.597–4.103) for stage 4; for cardiovascular mortality, HRs were 1.406 (95% CI: 0.582–3.393), 2.910 (95% CI: 1.108–7.644), and 5.960 (95% CI: 2.158–16.458).

Conclusion

Progression of CKM syndrome was linked to increased all-cause and cardiovascular mortality among cancer survivors, underscoring the need for early recognition and intervention.

Trial registration

Not applicable.