Background: In recent decades, numerous cohorts have been established to investigate cardiovascular disease (CVD) and mortality among young cancer patients.(1,2) However, these cohorts rarely include young females with cervical cancer, a disease often treated surgically and associated with human papillomavirus (HPV) infection. HPV infections, which can be prevented through vaccination, has also been associated to an elevated risk of CVD. (3)

Purpose: The aim was to study CVD and mortality in young cervical cancer patients.

Method: Using the Rebuc study, which includes all young (<25 years) cancer patients in Sweden from 1958 to 2021. 30,507 individuals aged 15-24 years with cervical cancer (ICD-10 C53) were identified and compared to 152,276 matched controls with regard to CVD (ICD-10 I00–I99 and G45), all-cause mortality, and CV mortality.

Results: The median age at cervical cancer diagnosis was 23 years (IQR 22-24) and the median age at the study’s end was 41 years in both groups (IQR 29-59 vs. 29-60).

CVDs were identified in 5,460 cervical cancer patients (17.9%) and 24,113 controls (15.8%), (Odds ratio (OR) 1.16 95% CI 1.12-1.20 p<0.0001). The risk for ischemic heart disease was 42% higher in cervical cancer patients (OR 95%CI 1.31-1.54, p<0.0001), 54% higher for myocardial infarction (OR 95%CI 1.38-1.72 p<0.0001), 35% higher for heart failure (OR 95% CI1.38-1.72 p<0.0001), and 38% higher risk for cerebrovascular diseases (OR 95%CI 1.26-1.50 p<0.0001) compared to controls.

The risk for all-cause mortality was 64% higher, and the risk for cardiovascular death was 49% higher among females with cervical cancer compared to controls. (Hazard Ratio 95%CI 1.52-1.76; and 1.29-1.70 p <0.0001). Myocardial infarction, sudden cardiac death, and heart failure was the most common cardiovascular causes of death in these young females.

Conclusion: Young females with cervical cancer are at a higher risk of severe CVD and mortality compared to controls. These findings highlight the importance of cardiovascular risk evaluation in cancer patients and contribute to the growing evidence supporting a broad implementation of HPV vaccination programs to reduce the burden of HPV-related diseases.