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New details on the link between CVD and cancer, from a study of 27M patients

Michael Walter

Individuals with cardiovascular disease (CVD) face a much higher risk of developing cancer than those without CVD, according to new findings published in JACC: CardioOncology.[1] The cancer risk is even higher, researchers noted, for individuals with atherosclerotic CVD.

“CVD and cancer continue to represent the two leading causes of death in the United States,” wrote first author Caitlin F. Bell, MD, a fellow in the department of medicine at Stanford University School of Medicine, and colleagues. “These diseases share a multitude of risk factors, underscored by the reduction in mortality from both conditions when patients adhere to cardiovascular risk reduction guidelines. However, it is becoming increasingly clear that the two diseases may have a more complicated relationship, including shared pathophysiological mechanisms that extend beyond traditional risk factors.”

The group’s analysis included data from a whopping 27.2 million cancer-free patients. There was a minimum of three years of follow-up data available for each patient.

Overall, the group found, patients diagnosed with CVD were 12% more likely to develop cancer. Patients with atherosclerotic CVD, meanwhile, faced a higher cancer risk than patients with other forms of CVD.

In addition, patients with atherosclerotic CVD had “a significantly higher risk” of “cancers of the lung, bladder, colon, head and neck, liver, prostate, pancreas, and kidney, as well as lymphoma, leukemia and other hematologic malignancies” than patients with nonatherosclerotic CVD.

Why is there such a link between these two leading causes of death? The authors wrote that, yes, shared risk factors do appear to play a role, but that may just be the tip of the iceberg.

“It is enticing to hypothesize that these links between CVD and specific cancer subtypes are mediated through shared biological processes (eg, inflammation, metabolic adaptations, etc.),” they wrote.

Research are actively investigating this possibility, but it is still far too early to make any judgements. Bell et al. also wrote that there is some evidence of “pathophysiological overlap between cancer and CVD independent of shared traditional risk factors.”

“Genome-wide association studies have shown that the most important commonly inherited genetic variant associated with atherosclerosis resides in a well-known cancer locus at chromosome 9p21, rather than in a gene that regulates traditional CV risk factors,” they wrote. “Inflammation and immune cell activation have also been linked to both conditions.”

The authors concluded by calling for even more research into this relationship between CVD and cancer. It is important, for example, to learn if certain groups of CVD patients should be exposed to cancer prevention tools or screening protocols.

Click here to read the full study in JACC: CardioOncology, a publication of the American College of Cardiology.


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