Five-year cancer incidence after new cardiovascular disease: a population study
P Moliner, H Morillas, A Ricarte-Marin, N Lopez-Fernandez, S Jovells-Vaque, A E Cosa, A Pons-Riverola, A Garay, S Jimenez-Marrero, R Ramos, J Berdejo, C Enjuanes, E Hidalgo-Quiros, M Soler, J Comin-ColetAbstract
Background
Patients with cardiovascular disease (CVD) have an increased risk of cancer, partly due to shared risk factors, chronic inflammation and systemic mediators. However, most previous studies have focused on individuals with pre-existing CVD. Whether patients with a new diagnosis of CVD are at particularly high risk of incident cancer, and whether the spectrum of cancer types differs from that of the general population, remains insufficiently explored.
Purpose
To describe the five-year incidence of cancer in patients with a new diagnosis of CVD in our healthcare area and to compare the distribution of cancer types with that reported in the general population.
Methods
We conducted a population-based cohort study using clinical databases from our healthcare area. All adults (>18 years) without a previous history of cancer who were newly diagnosed with CVD between 2010 and 2022 were included. Incident cancers diagnosed between 3 months and 5 years after the index CVD diagnosis were recorded. The incidence and distribution of cancer types were analysed and compared with data from the general population.
Results
A total of 9,900 patients with newly diagnosed CVD and no prior cancer history were identified. The mean age of the cohort was 64 years, 43% were women, and comorbidities were frequent. During follow-up, 1,922 patients (19.4%) developed incident cancer within five years. Patients who developed cancer were more often male, older, and had a higher burden of comorbidities than those who did not. Among CVD subtypes, chronic heart failure was associated with the highest risk of incident cancer. The most frequently diagnosed cancers were gastrointestinal (27%), lung (14.5%), genitourinary (13.5%) and male reproductive system cancers (13.4%).
Conclusions
In our healthcare area, the five-year incidence of cancer following a new diagnosis of CVD was markedly high. Moreover, 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. These findings highlight the importance of cancer awareness and surveillance strategies in patients with newly diagnosed CVD.Table.Basal characteristics. Figure.Types of incident cancer.