HF Mortality Cancer Comparison — EECC MCQ

Correct answer: E — Five-year mortality for HFrEF (NYHA III-IV) remains 40-50% despite modern GDMT — worse than many common cancers (breast, prostate, bowel); this underscores the severity of HF and the importance of GDMT optimisation, device therapy, and timely referral for advanced therapies

Despite advances in GDMT, HF remains a condition with sobering mortality: (1) 5-year mortality: NYHA I-II ~20-30%; NYHA III-IV ~40-50% (improving with quadruple GDMT but still high); (2) comparison with common cancers: HF 5-year mortality is worse than breast cancer (5-year survival ~87%), prostate cancer (~88%), and bowel cancer (~60%); comparable to bladder or ovarian cancer. This comparison is frequently used to emphasise to patients and healthcare systems: (1) the seriousness of HF; (2) the critical importance of GDMT optimisation (each untitrated agent represents missed mortality benefit); (3) the need for HF specialist services, multidisciplinary teams, and palliative care integration; (4) the urgency of timely referral for advanced therapies (LVAD, transplant) in appropriate patients. The ESC HF Guidelines emphasise that HF should be treated with the same urgency as serious malignancies.

Reference: ESC (2023): HF Guidelines