Aug 2026· European Heart Journal, Supplement· Vol 28· 0 citations
TL;DR
Patients with newly diagnosed CVD present a higher risk of cancer when compared to patients without a history of prior CVD, and men show a higher risk of incident cancer over time when patients with CVD are subclassified by biological sex, when patients with CVD are subclassified by biological sex.
Abstract
Cardiovascular disease (CVD) and cancer share common risk factors and pathophysiological pathways. Previous studies have shown that patients with prevalent CVD present an increased risk of developing cancer in the future. Nevertheless, the effect of biological sex on cancer incidence after a recent cardiovascular event remains largely unexplored.
To analyze the influence of biological sex on mid-long term incidence of cancer in patients with a new diagnosis of CVD. To evaluate the impact of sex on cancer outcomes according to the concrete type of cardiovascular event.
We performed a retrospective population-based cohort study using data from 2010-2022 clinical and administrative databases from our healthcare area. All adults (>18 years) without a prior history of cancer or CVD at first medical contact were included. During a run-in period of 24 months, patients with a new diagnosis of cancer or CVD were excluded. After this initial timeline, patients were classified into 2 groups in a dynamic manner depending on the presence or absence of new CVD, as defined by International Classification of Disease (ICD) 9th and 10th editions. The primary outcome of interest was incident cancer, also ascertained by means of ICD codes after the 24-month run-in period. Nonmelanoma skin cancers were not included. Statistical analysis comprised cox proportional hazards models adjusted for age, diabetes, hypertension, dyslipidemia and smoking.
A total of 238,415 adults were included, of whom 52.20% were women. Compared to men, women were older (45.9 vs 43.7 years, p<0.01) and had a higher prevalence of anemia (10.73 vs 45.8%, p<0.01= and depression (5.48% vs 2.40%, p<0.01), whilst men presented a greater history of alcohol abuse (5.75% vs 1.15%, p<0.01) and chronic obstructive pulmonary disease (5.92% vs 3.14%, p<0.01). When compared to patients without a prior history of CVD, patients with a new diagnosis of CVD showed an increased risk of incident cancer over time, with and adjusted hazard ratio (HR) of 1.56 (95%CI 1.47-1.67) (picture 1). When stratified by biological sex, cancer incidence was similar between males and females without prior CVD. Nevertheless, in the subgroup of patients with a new diagnosis of CVD, men exhibited a higher risk of cancer over time compared to women (HR 1.13; 95%CI 1.08-1.18; picture 2). Regarding type of CVD, men showed a higher risk of incident cancer in relation to women when the cardiovascular event was heart failure, coronary heart disease or cerebrovascular disease, but not in the case of atrial fibrillation.
Patients with newly diagnosed CVD present a higher risk of cancer when compared to patients without a history of prior CVD. When patients with CVD are subclassified by biological sex, men show a higher risk of incident cancer over time.Cancer Incidence Stratified by Presence Cancer Incidence Stratified by Sex and P
In this population-based cohort study, the five-year incidence of cancer following a new diagnosis of CVD was markedly high and the distribution of cancer types in this population differed from that of the general population, with a higher proportion of genitourinary cancers and a lower proportion of breast cancer.
P. Moliner, H. Morillas, A. Ricarte-Marin et al.· European Heart Journal, Supp...· 0 citations
BACKGROUND AND AIMS
The incidence of cancer in people with cardiovascular disease (CVD) is poorly understood. This study aimed to understand the sex differences in incident cancer and cancer-related mortality in people with and without CVD.
METHODS
Participants were drawn from the European Prospective Investigation into Cancer (EPIC)-Norfolk study and followed up for a median of 26.2 years. Participants were stratified by sex and incident CVD during follow-up. Cumulative cancer incidence was calculated for each group. Sex-specific lifetime risks of cancer were determined, accounting for competing risks of death. Cause-specific hazard ratios (HRs) were determined using Royston-Parmar models, adjusted for ethnicity and time-updated covariates, including deprivation index, cardiovascular risk factors, comorbidities, and medication. Participants' CVD status was updated throughout follow-up.
RESULTS
A total of 22 534 participants were cancer-free at baseline (57% women; mean age 58.6 ± 9.3 and 59.5 ± 9.3 for women and men, respectively); 10 889 participants either had prevalent CVD at baseline or developed CVD during follow-up. Men had more comorbidities. The adjusted lifetime risk of incident cancer in CVD participants at age 75 was higher in men (17.3%) than in women (12.8%), with a significant cause-specific HR of 1.39 (99% confidence interval [CI] 1.25-1.53, P < .0001). Corresponding data for participants with no CVD were 10.2% for men and 8.2% for women, with an HR of 1.27 (99% CI 1.15-1.41, P < .0001 for men vs women). A similar trend exists for cancer-related mortality (HR 1.51, 99% CI 1.31-1.75, P < .0001 for men with CVD and HR 1.31, 99% CI 1.14-1.50, P < .0001 for men without CVD).
CONCLUSIONS
This study showed an increased lifetime cancer risk and mortality in men compared with women, which was mediated by comorbid CVD.
R. Thuemmler, T. Pana, M. Mamas et al.· European Heart Journal· 0 citations
– Emerging evidence has revealed that cardiovascular diseases (CVDs) identify individuals prone to developing cancer. However, the precise impact and which CVD is most associated with future cancer is not clear. Therefore, we present an up-to-date impact of CVD on cancer incidence and cancer-related mortality.
– A scoping review with a systematic approach was performed in adherence to the guidelines of Transparent Reporting of Systematic Reviews and Meta-analyses (PRISMA). Studies evaluating cancer incidence and mortality among individuals with pre-existing CVD or cardiovascular (CV) risk assessments were included. To categorize the data, sub-groups were created: 1) coronary artery disease, 2) atrial fibrillation, 3) congenital heart disease, 4) heart failure, 5) hypertension, 6) thrombosis, and 7) cardiovascular health indicators. Various predictor indices were plotted in forest plots to visualize effect of CVD or CV health indicators on cancer incidence and cancer-related mortality.
– The search strategy and screening process yielded 47 full-text articles for data-extraction. All CVDs and CV health indicators demonstrated an overall elevated risk of future cancer or cancer-related mortality (Figure 1). In the current evaluation, atrial fibrillation, congenital heart disease and thrombosis presented the strongest associations. Additionally, sex differences were subtle but present, favoring women.
– This scoping review highlights that the manifold of CVD and CV health indicators increase the risk of new-onset cancer and cancer-related mortality. Together, these findings emphasize the need for awareness of future cancer in patients with CVD as well as further in-depth studies for proper comparisons.
L. Yousif, P. Ameri, M. Vinci et al.· European Heart Journal, Supp...· 0 citations
Evaluating the occurrence of new-onset CVD in women with breast cancer undergoing chemotherapy and identifying factors associated with increased risk of cardiovascular disease highlights the need for sustained cardiovascular surveillance in breast cancer survivors.
V. Dvorovy, L. Kováčová, M. Selvek et al.· European Heart Journal, Supp...· 0 citations
The burden of pre-existing CVD at cancer diagnosis has increased substantially over the past two decades in the UK and is projected to rise further, highlighting the growing need for integrated prevention strategies and cardio-oncology services to address increasing multimorbidity in patients with cancer.
A. Alshahrani, E. Kontopantelis, C. Morgan et al.· European Heart Journal, Supp...· 0 citations
BACKGROUND AND AIMS
Advances in cancer care have improved survival, increasing the importance of comorbidities at diagnosis for longer-term outcomes. Pre-existing cardiovascular disease (CVD) can complicate management and prognosis, yet its long-term trends and future burden at cancer diagnosis are unclear. This study aimed to quantify temporal trends in pre-existing CVD among patients with newly diagnosed cancer and project prevalence through 2050.
METHODS
Linked primary care, cancer registry, and hospitalization records were used to identify 773 590 adults (≥18 years) diagnosed with the five most common cancers between 2001 and 2020 in England. Serial cross-sectional analyses estimated annual crude and age-standardized prevalence of pre-existing CVD and comorbidities. Temporal trends were assessed using logistic regression adjusted for demographics and cancer type. The contributions of changes in risk factor domains were evaluated using sequential modelling, and CVD prevalence was projected to 2050 using demographic-adjusted spline models.
RESULTS
The age-standardized prevalence of pre-existing CVD rose from 31.4% [95% confidence interval (CI) 31.2-31.6] in 2001-2005 to 39.2% (95% CI 39.0-39.4) in 2016-2020, with the steepest increases in lung and haematological cancers. Valvular disease, heart failure, atrial fibrillation, and diabetes showed the largest subtype rises. Sequential modelling showed the greatest attenuation of the temporal trend after adjustment for cardiometabolic conditions and chronic comorbidities. Projection analyses suggest that, if current temporal patterns continue, approximately half of patients may present with pre-existing CVD at cancer diagnosis by 2050.
CONCLUSIONS
Pre-existing CVD at cancer diagnosis has increased substantially over 2 decades and is projected to affect nearly half of patients by 2050. These trends underscore the need for the expansion of cardio-oncology services.
A. Alshahrani, E. Kontopantelis, C. Morgan et al.· European Heart Journal· 0 citations
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