Cardiovascular disease risk in cancer survivors: a population-based cohort study from the UK Biobank, and meta-analysis of cohort studies
Introduction In addition to the well-recognised cardiotoxicity of cancer treatment, possible aetiological links between cancer diagnosis and cardiovascular disease (CVD) have gained growing research interests. We aimed to estimate the CVD burden among cancer survivors and illustrate population-level...
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BMJ Publishing Group
2025-01-01
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| author | Hong Li Yazhou He Zubing Mei Hong Wu Yang Shen Ziqiang Wang Jichun Zhao Chuan Xu Yanhong Zhou Chi Shu Botao Yu Xiran Wang Changtao Li Yiqiang Liu |
| author_facet | Hong Li Yazhou He Zubing Mei Hong Wu Yang Shen Ziqiang Wang Jichun Zhao Chuan Xu Yanhong Zhou Chi Shu Botao Yu Xiran Wang Changtao Li Yiqiang Liu |
| author_sort | Hong Li |
| collection | DOAJ |
| description | Introduction In addition to the well-recognised cardiotoxicity of cancer treatment, possible aetiological links between cancer diagnosis and cardiovascular disease (CVD) have gained growing research interests. We aimed to estimate the CVD burden among cancer survivors and illustrate population-level associations between these two conditions.Methods We first conducted a prospective cohort study in the UK Biobank and a meta-analysis of previous population-based cohorts. HRs were estimated in the cohort study to evaluate the effect of cancer diagnosis on the subsequent risk of CVD compared with that of non-cancer individuals. We then systematically searched Pubmed, Embase and Cochrane Library to retrieve previous cohorts. Random-effect meta-analysis was performed to pool relative risk estimates. A combination of multiple statistical metrics was employed to appraise the evidence.Results A total of 39 755 811 participants (5 898 597 cancer survivors vs 33 857 214 cancer-free controls) were identified in our study. In the cohort study, a 51% higher hazard of CVD risk was found among cancer survivors (95% CI 1.48 to 1.55, p<0.001). The hazard decreased to 29% after adjusting competing risk. The meta-analysis identified 104 published cohorts. We found a 1.34-fold increased CVD risk among patients with cancer (95% CI 1.22 to 1.47, p<0.001). The association remains significant among multiple cancer sites and multiple CVD subtypes. This association was consistent, irrespective of chemo or radiotherapy use. Evidence appraisal identified one convincing association between hematologic/lymphatic malignancies and ischaemic heart disease, along with 29 highly suggestive associations.Conclusions Our study provided comprehensive estimates of CVD incidence in cancer survivors and identified a significantly elevated CVD risk among patients with cancer, regardless of chemotherapy or radiotherapy. These findings underscore the need for routine assessment of CVD risk factors at cancer diagnosis to enhance the well-being and survival of patients with cancer.PROSPERO registration numberCRD42022307056 |
| format | Article |
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| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Public Health |
| spelling | doaj-art-79be6631059047299229932b9b4651d02025-01-27T09:20:11ZengBMJ Publishing GroupBMJ Public Health2753-42942025-01-013110.1136/bmjph-2024-001303Cardiovascular disease risk in cancer survivors: a population-based cohort study from the UK Biobank, and meta-analysis of cohort studiesHong Li0Yazhou He1Zubing Mei2Hong Wu3Yang Shen4Ziqiang Wang5Jichun Zhao6Chuan Xu7Yanhong Zhou8Chi Shu9Botao Yu10Xiran Wang11Changtao Li12Yiqiang Liu13Department of Delivery Unit of Affiliated Lujun Zong Hospital of Chongqing City, Sichuan Province, 400037, China2 Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UKDepartment of Anorectal Surgery, Anorectal Disease Institute of Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaShanghai Municipal Health Commission, Shanghai, ChinaDepartment of Oncology & Cancer Institute, Sichuan Academy of Medical Sciences, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China Sichuan Provincial People`s Hospital, Chengdu, Sichuan, ChinaDepartment of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China1 Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Sichuan Province, China1 Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, ChinaDepartment of Anesthesia, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, ChinaDivision of Vascular Surgery, Department of General Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, ChinaEmergency Department, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Hospital), Qingdao, Shandong, ChinaDepartment of Oncology & Department of Epidemiology and Medical Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Oncology & Department of Epidemiology and Medical Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Oncology & Cancer Institute, Sichuan Academy of Medical Sciences, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China Sichuan Provincial People`s Hospital, Chengdu, Sichuan, ChinaIntroduction In addition to the well-recognised cardiotoxicity of cancer treatment, possible aetiological links between cancer diagnosis and cardiovascular disease (CVD) have gained growing research interests. We aimed to estimate the CVD burden among cancer survivors and illustrate population-level associations between these two conditions.Methods We first conducted a prospective cohort study in the UK Biobank and a meta-analysis of previous population-based cohorts. HRs were estimated in the cohort study to evaluate the effect of cancer diagnosis on the subsequent risk of CVD compared with that of non-cancer individuals. We then systematically searched Pubmed, Embase and Cochrane Library to retrieve previous cohorts. Random-effect meta-analysis was performed to pool relative risk estimates. A combination of multiple statistical metrics was employed to appraise the evidence.Results A total of 39 755 811 participants (5 898 597 cancer survivors vs 33 857 214 cancer-free controls) were identified in our study. In the cohort study, a 51% higher hazard of CVD risk was found among cancer survivors (95% CI 1.48 to 1.55, p<0.001). The hazard decreased to 29% after adjusting competing risk. The meta-analysis identified 104 published cohorts. We found a 1.34-fold increased CVD risk among patients with cancer (95% CI 1.22 to 1.47, p<0.001). The association remains significant among multiple cancer sites and multiple CVD subtypes. This association was consistent, irrespective of chemo or radiotherapy use. Evidence appraisal identified one convincing association between hematologic/lymphatic malignancies and ischaemic heart disease, along with 29 highly suggestive associations.Conclusions Our study provided comprehensive estimates of CVD incidence in cancer survivors and identified a significantly elevated CVD risk among patients with cancer, regardless of chemotherapy or radiotherapy. These findings underscore the need for routine assessment of CVD risk factors at cancer diagnosis to enhance the well-being and survival of patients with cancer.PROSPERO registration numberCRD42022307056https://bmjpublichealth.bmj.com/content/3/1/e001303.full |
| spellingShingle | Hong Li Yazhou He Zubing Mei Hong Wu Yang Shen Ziqiang Wang Jichun Zhao Chuan Xu Yanhong Zhou Chi Shu Botao Yu Xiran Wang Changtao Li Yiqiang Liu Cardiovascular disease risk in cancer survivors: a population-based cohort study from the UK Biobank, and meta-analysis of cohort studies BMJ Public Health |
| title | Cardiovascular disease risk in cancer survivors: a population-based cohort study from the UK Biobank, and meta-analysis of cohort studies |
| title_full | Cardiovascular disease risk in cancer survivors: a population-based cohort study from the UK Biobank, and meta-analysis of cohort studies |
| title_fullStr | Cardiovascular disease risk in cancer survivors: a population-based cohort study from the UK Biobank, and meta-analysis of cohort studies |
| title_full_unstemmed | Cardiovascular disease risk in cancer survivors: a population-based cohort study from the UK Biobank, and meta-analysis of cohort studies |
| title_short | Cardiovascular disease risk in cancer survivors: a population-based cohort study from the UK Biobank, and meta-analysis of cohort studies |
| title_sort | cardiovascular disease risk in cancer survivors a population based cohort study from the uk biobank and meta analysis of cohort studies |
| url | https://bmjpublichealth.bmj.com/content/3/1/e001303.full |
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