Poster Presentation NSW State Cancer Conference 2023

Prevalence of Australians exposed to potentially cardiotoxic cancer medicines (#300)

Benjamin Daniels 1 , Maria Aslam 2 , Marina van Leeuwen 3 , Martin Brown 4 , Lee Hunt 5 , Howard Gurney 6 , Monica Tang 1 , Sallie Pearson 1 , Claire Vajdic 7
  1. Medicines Intelligence Research Program, School of Population Health, UNSW Sydney, Sydney, NSW, Australia
  2. Cancer Services, Hunter New England Local Health District, Hunter Medical Research Institute, Newcastle, NSW, Australia
  3. Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW, Australia
  4. Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
  5. Cancer Voices NSW, Sydney, NSW, Australia
  6. Medical Oncology, St George Hospital, Sydney, NSW, Australia
  7. Kirby Institute, University of New South Wales, Sydney, NSW, Australia

Background

Cardiovascular disease (CVD) and cancer are leading causes of death and people with cancer are at higher risk of developing CVD than the general population. Many cancer medicines have cardiotoxic effects but the size of the population exposed to these potentially cardiotoxic medicines is not known. We aimed to determine the prevalence of exposure to potentially cardiotoxic cancer medicines in Australia.

Methods

We identified potentially cardiotoxic systemic cancer medicines through searching the literature and registered product information documents. We conducted a retrospective cohort study using a random 10% sample of Pharmaceutical Benefits Scheme (PBS)-eligible Australians and their PBS dispensing claims, 2005–2021. We calculated age-standardised annual prevalence rates of people alive with exposure to a potentially cardiotoxic medicine during or prior to each year of the study period.

Results

We identified 108,175 people dispensed at least one potentially cardiotoxic cancer medicine; median age, 64 (IQR: 52–74); 57% female. Overall prevalence increased from 49 (95%CI: 48.7–49.3)/10,000 to 232 (95%CI: 231.4–232.6)/10,000 over the study period; 61 (95%CI: 60.5–61.5)/10,000 to 293 (95%CI: 292.1–293.9)/10,000 for females; and 39 (95%CI: 38.6–39.4)/10,000 to 169 (95%CI: 168.3–169.7)/10,000 for males. People alive five years following first exposure increased from 29 (95%CI: 28.8–29.2)/10,000 to 134 (95%CI: 133.6–134.4)/10,000; and from 22 (95%CI: 21.8–22.2)/10,000 to 76 (95%CI: 75.7–76.3)/10,000 for those alive at least 10 years following first exposure. Most people were exposed to only one potentially cardiotoxic medicine, rates of which increased from 39 (95%CI: 38.7–39.3)/10,000 in 2005 to 131 (95%CI: 130.6–131.4)/10,000 in 2021.

Conclusions

The number of people exposed to efficacious yet potentially cardiotoxic cancer medicines in Australia is growing. Our findings can support the development of service planning and create awareness about the magnitude of cancer treatment-related cardiotoxicities. Future efforts should focus on ongoing monitoring and surveillance of both exposures and outcomes so that resources can be directed to the needs of the population.