Contributions of Cancer Treatment, Comorbidities, and Obesity to Aging-related Disease Risks among Non-Hodgkin’s Lymphoma Survivors

Abstract Purpose. It is unknown whether cancer treatment or modifiable risk factors contribute more to the burden of long-term disease risks among B-cell non-Hodgkin’s lymphoma (B-NHL) survivors. Methods. B-NHL survivors were identified in the Utah Cancer Registry from 1997 to 2015. Population attributable fractions (PAF) were calculated to assess the role of clinical and lifestyle factors for 6 cardiovascular, pulmonary, and renal diseases. Results. Cancer treatment contributed to 11% of heart and pulmonary conditions and 14.1% of chronic kidney disease. Charlson Comorbidity Index (CCI) at baseline contributed to all six diseases with a range of 9.9% of heart disease to 26.5% of chronic kidney disease. High BMI at baseline contributed to 18.4% of congestive heart failure and 7.9% of pneumonia, while smoking contributed to 4.8% of COPD risk. Conclusion. Cancer treatment contributed more to heart disease, COPD, and chronic kidney disease among B-NHL survivors. High BMI at baseline contributed more to congestive heart failure and pneumonia than cancer treatment, whereas smoking at baseline was not a major contributor in this B-NHL survivor cohort. Baseline comorbidities consistently demonstrated high attributable risks for these diseases, demonstrating a strong association between preexisting comorbidities and aging-related disease risks.