Presence of CVD, especially atherosclerosis, could increase cancer risk
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Key takeaways:
- Cardiovascular disease, especially ASCVD, was tied to increased risk for cancer.
- Bladder, colon and lung cancer and lymphoma, leukemia and other hematologic malignancies were most common in those with ASCVD.
Cardiovascular disease, especially atherosclerotic CVD, was associated with increased risk for cancer diagnosis, according to a study published in JACC: CardioOncology.
“Even after you control for shared risk factors like smoking, individuals with CVD, in particular ASCVD, have a meaningfully increased risk of cancer,” Kevin T. Nead, MD, MPhil assistant professor in the department of epidemiology, division of OVP and cancer prevention and population sciences, at The University of Texas MD Anderson Cancer Center, told Healio. “Our finding bolsters the hypothesis that cancer and CVD share pathophysiological mechanisms that extend beyond traditional risk factors.”
Image: Adobe Stock
Nead and colleagues utilized IBM MarketScan claims data to identify more than 27 million individuals without cancer and at least 36 months of follow-up and stratified them by CVD status (mean age, 43 years; 56% women). The researchers estimated cumulative risk for cancer using time-varying analysis with multivariable adjustment for CV risk factors.
During a median follow-up of 33 months, Nead and colleagues observed that individuals with CVD had a 12% greater risk for developing cancer compared with those without CVD (HR = 1.12; 95% CI, 1.11-1.13).
The researchers conducted additional analyses based on CVD type — atherosclerotic compared with nonatherosclerotic — and the 20 most frequently diagnosed cancer subtype.
Though cancer risk was elevated among all participants with CVD, risk was especially high among individuals with ASCVD compared with those without CVD (HR = 1.2; 95% CI, 1.19-1.21) and compared with nonatherosclerotic CVD (HR = 1.11; 95% CI, 1.11-1.12).
Both ASCVD and nonatherosclerotic CVD were associated with increased risk for many of the most frequently diagnosed cancer subtypes compared with individuals without CVD, according to the study.
After adjustment for smoking status and BMI, ASCVD was associated with greater risk for the following cancer subtypes compared with nonatherosclerotic CVD:
- bladder cancer (HR = 1.58; 95% CI, 1.24-2.01);
- colon cancer (HR = 1.53; 95% CI, 1.16-2.01);
- lung cancer (HR = 1.43; 95% CI, 1.17-1.74);
- lymphoma (HR = 1.42; 95% CI, 1.19-1.71);
- leukemia (HR = 1.4; 95% CI, 1.06-1.85); and
- other hematologic malignancies (HR = 1.42; 95% CI, 1.11-1.82).
“The most surprising finding of our study was that CVD had a differential impact on different type of cancer. For example, while ASCVD was associated with an increased risk for most cancers, it protected against cancers that are typically hormone driven, such as cancers of the breast, ovaries and uterus,” Nead told Healio. “This study reinforces that when caring for patients with CVD, adherence to established cancer screening practices is critical regardless of exposure to shared risk factors.”
For mor information:
Kevin T. Nead, MD, MPhil, can be reached at ktnead@mdanderson.org.
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