Long-term vascular health effects of cancer and its treatment (360G-Wellcome-220283_Z_20_Z)

There is increasing concern about the long-term vascular health of the large and growing population of cancer survivors. I recently showed that survivors of most types of cancer have increased risks of one or more cardiovascular diseases, beyond those explained by shared risk factors such as smoking. The key priorities now are to understand (i) the drivers of these increased risks, and thus how and when we can most effectively intervene; and (ii) whether broader vascular-related outcomes, in particular dementia and kidney disease, are also affected. In this fellowship I will address these two priorities by conducting analyses underpinned by cutting-edge statistical and epidemiological methods, and capitalising on rich UK and international e-Health datasets, including game-changing new cancer treatment data. I will investigate in detail the role of anti-cancer treatments (e.g. chemotherapies/radiotherapy) and changes in traditional vascular risk factors (e.g. blood pressure, BMI) in driving late cardiovascular risk. I will then investigate whether, and through what mechanisms, cancer history affects risk of vascular dementia, chronic kidney disease, and pre-clinical cognitive and renal outcomes (uniquely identifiable in the 500,000-strong UK Biobank cohort). Throughout, this research will contribute actionable evidence informing clinical/public health policies to improve the long-term outlook of cancer survivors.