Aug 2026· Clinical and Experimental Medicine (Testo stampato)· 0 citations
TL;DR
A substantial cardiovascular burden among cancer patients is confirmed while highlighting important limitations in the evidence base, and strengthening integrated cardio-oncology care and prioritising high-quality research are essential to improve risk stratification and patient outcomes.
Abstract
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among cancer survivors, driven by the cancer itself, its treatments, and shared risk factors. Despite numerous systematic reviews and meta-analyses, the evidence remains fragmented and inconsistent, limiting its clinical utility. This umbrella review synthesised evidence on the incidence of CVD and CVD-related mortality after a cancer diagnosis and critically appraised the methodological quality of the literature. A comprehensive search of PubMed, Embase, CINAHL, Web of Science, and the Cochrane Library from inception to February 2025 identified 34 eligible reviews from 12,942 records. Cancer patients consistently showed higher risks of CVD (relative risks, 1.11–2.32) and CVD-related mortality (hazard ratios, 1.09–1.70) compared with cancer-free populations, with variation by cancer type and CVD subtype. Reported outcomes included stroke, atrial fibrillation, and thromboembolic events, with evidence also indicating that patients with pre-existing CVD may develop additional cardiovascular events after cancer diagnosis. The methodological quality of included reviews ranged from critically low to moderately high, with none rated as high quality. These findings confirm a substantial cardiovascular burden among cancer patients while highlighting important limitations in the evidence base. Strengthening integrated cardio-oncology care and prioritising high-quality research are essential to improve risk stratification and patient outcomes.
BACKGROUND
Cancer and heart failure (HF) frequently coexist due to population ageing and improved survival for both conditions. HF is a well-recognised complication of oncologic therapies and a potential association between HF and subsequent cancer incidence has been recently noticed. We therefore conducted a meta-analysis to quantify cancer incidence and mortality in patients with and without HF.
METHODS
Databases were searched from inception to 15 February 2026. Data from observational studies and randomised trials on individuals with and without HF and reporting cancer incidence and/or mortality during follow-up were included. The main outcome of interest was the incidence of any cancer; secondary outcomes included site-specific cancer incidence (lung, colorectal, breast, and prostate) and all-cause, cardiovascular, and cancer-related mortality.
RESULTS
Twelve studies comprising 8,979,195 individuals were included. HF was associated with a higher incidence of cancer (hazard ratio [HR] 1.33, 95% confidence interval [CI] 1.14-1.54), with substantial heterogeneity (I2 = 99.7%). Cancer site-specific analyses showed increased incidences of lung (HR 1.70, 95% CI 1.26-2.29), colorectal (HR 1.28, 95% CI 1.11-1.48), and breast (HR 1.19, 95% CI 1.04-1.37), but not prostate, cancer. Effect estimates varied according to analytical strategy: matched HF and non-HF cohorts reported higher risk estimates than those using covariate adjustment without matching. Mortality data were sparse and heterogeneous.
CONCLUSIONS
HF is associated with a higher incidence of cancer, although with marked heterogeneity among studies and cancer types. Mortality and cause of death were rarely reported. The observed HF-cancer association is influenced by statistical methodology, shared risk factors, differences in surveillance intensity and cancer type, that confound analyses investigating possible causal biological links. More granular and harmonised studies are required.
L. Sanasi, A. Iaconelli, Danila Azzolina et al.· European Journal of Heart Fa...· 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
It is recommended that patients with lung cancer undergo screening to assess their cardiovascular risk and related complications and it is recommended that patients with lung cancer undergo screening to assess their cardiovascular risk and related complications.
M. Mamedov, P. I. Skopin, A. K. Karimov· Russian Journal of Preventiv...· 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
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
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
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