People with heart failure may be at increased risk for cancer.
Cancer patients are usually watched for heart failure, as some anti-cancer drugs can damage the heart. Now, a new study suggests that patients with heart failure, who can live for many years with the disease, may benefit from follow-up for cancer.
The researchers used a German health database to follow 100,124 heart failure patients, comparing them with the same number of controls who did not have heart failure. All were cancer free at first, and scientists followed their cancer incidence over the next 10 years. The study is published in the journal ESC Heart Failure.
The two groups were matched for age, sex, age, obesity, and incidence of diabetes, although researchers lacked data on socioeconomic status, smoking, alcohol consumption. and physical activity, all of which are known to affect cancer risk.
However, the differences in cancer incidence between the two groups were significant. Overall, 25.7% of heart failure patients were diagnosed with some form of cancer, compared to 16.2% of those without.
The increased rate of cancer in heart patients has been found in other studies, but the large sample size in this analysis allowed researchers to note differences between cancer types. Patients with heart failure had more than double the risk of cancer of the lip, oral cavity and pharynx. The risk was 91 percent higher for lung cancer and other respiratory cancers, 86 percent higher for female genital cancers, and 83 percent higher for skin cancers. People with heart failure had a 75% higher risk of colon cancer, stomach cancer, and other cancers of the digestive system. Women with heart failure had a 67% higher risk of breast cancer, and men a 52% higher risk of genital cancer.
“I think this is an interesting retrospective cohort study,” said Dr. Girish L. Kalra, senior cardiology investigator at UCLA’s David Geffen School of Medicine, who was not involved. to work. “The main disadvantage of the study is that the database did not allow researchers to control the greatest risk of developing cancer and heart disease: smoking. Smoking may be the common thread of this study.
Yet although the strong link to oropharyngeal and respiratory tract cancers suggests that smoking may be an explanation, the association has remained strong for a wide range of cancers. The study also controlled for other factors linked to various cancers, including obesity, diabetes and aging, as well as the frequency of medical consultations, which could lead to increased detection of cancers.
In addition to smoking, there are other possible mechanisms that could explain the link. For example, a previous study found that a well-known protein biomarker for heart disease that appears even before symptoms appear is also correlated with an increased risk of cancer. It’s also possible, the researchers write, that chronic inflammation could be involved in both heart failure and cancer. Alcohol consumption has also been linked to a variety of cancers.
“There are more correlations between heart failure and cancer than just common risk factors,” said lead author Mark Luedde, cardiologist at the University of Kiel in Germany. “Heart failure is not a disease of the heart. It is almost always a disease of the heart and other organs. The importance of co-morbidities for the prognosis and quality of life of those affected cannot be overstated.
Dr Kalra agreed. “Ultimately, the heart is an indicator of all health,” he said. “This study supports the idea that people with heart failure are a high risk group and deserve our utmost attention. As physicians, we need to make sure that our heart patients are screened for cancer at the recommended time intervals. And we should continue to harass our smokers to quit.