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‹ Mon · 15 Jun 2026
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Heterogeneity in proportional cardiovascular co-listing on cancer death certificates in the United States: a national multiple cause-of-death analysis, 1999-2020

Tracking how often heart disease appears alongside cancer deaths reveals we may be undercounting treatment-related heart harm, enabling better long-term safety monitoring.

Analysis of 56 million US death certificates from 1999-2020 finds cardiovascular disease is co-listed on nearly 29% of cancer-related deaths, with leukemia showing the highest proportional CVD co-listing in young adults (PMR 2.174) and a significant increasing trend over 22 years. The study introduces a PMR framework for population-level cardiotoxicity surveillance applicable to administrative data where person-time denominators are unavailable.

What the study was

Study design
National cross-sectional surveillance analysis
Population
US death certificates 1999-2020, adults ≥15 years
Sample size
56014102
Category
Public Health
Maturity
Validated
Journal
Cardio-oncology

Why it surfaced

Novel PMR framework for cardio-oncology surveillance; leukemia CVD signal noteworthy for watchlist; large dataset (56M). Scored 5 due to cross-sectional surveillance design and indirect clinical applicability.

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