Patients with cardiovascular disease are at higher risk of developing cancer and dying from cancer, according to new research.
Researchers at the University of Aberdeen and Keele University also found through a study of over 22,00 participants over a 25-year period that that men with cardiovascular disease are at a significantly higher risk than women with CVD of developing and dying from cancer – a that pattern that persisted across all subtypes of cancer.
While the link between cancer and cardiovascular disease (CVD) has long been established, this study was the first to explore the long term risk to CVD patients, as well as the specific difference in risk between sexes – which turned out to be stark.
Out of a cohort 22,534 in the UK, all who were cancer-free at baseline,10,889 participants either had prevalent CVD at baseline or developed CVD during follow-up.
Using the EPIC-Norfolk database to examine their long-term health records over an average of 26 years, it was found that the lifetime risk of cancer among people with CVD was significantly higher than those without CVD.
To Professor Mamas A Mamas, Professor of Cardiology at Keele University and co-author of the study, this was the foremost finding of the study. He told EMJ: “Most doctors and people know that if you have cancer, you’re much more likely to get cardiovascular disease.
“There’s many reasons for that, shared risk factors, the drugs that we use to treat the cancer can cause cardiovascular disease and some of the pathways that cause cancer also cause cardiovascular disease.
He added: “What isn’t as well known is whether having cardiovascular disease can increase your risk of cancer. I look after patients with cardiovascular disease all the time. We don’t really think about cancer.”
The relationship between sex and cancer risk in patients with cardiovascular disease was also significant.
For men with CVD, the risk of developing cancer was17.3%, compared to 12.8% for their female counterparts. For those without CVD, cancer risk was 10.2% among men and 8.2% for women.
The study also found that men in both the CVD group and the non-CVD group were also more likely to die from cancer compared with women.
The team suggest that the link between CVD, which includes a range of conditions affecting the heart and blood vessels such as coronary heart disease, atrial fibrillation, heart failure and stroke, and cancer is mediated by lifestyle risk factors.
Smoking, very high alcohol consumption and severe obesity were all noted as significant risk factors for men with CVD to develop cancer, as well as deprivation, hypertension and bronchitis.
For women with CVD, significant risk factors included diabetes, smoking, severe obesity and hypertension.
Significant risk factors for cancer mortality for men with CVD were similar and included bronchitis, smoking, and high and very high alcohol consumption. For women with CVD, significant risk factors included smoking and obesity.
Data also showed that non-melanoma skin cancer, lung cancer, and colorectal cancer were the most prevalent types of cancer amongst the cohort, while men with CVD were more likely to die from gastric, oesophageal, and lung cancer mortality compared to their non-CVD counterparts.
Professor Mamas said: “This is the second most significant finding from this study. This shows there are important differences between men and women in cancer risk.
“One of the arguments for why people may not have found any relationship before is because they’ve just not looked for long enough. Many of the other pieces of work that have been done in the past are limited by really short follow-ups, maybe three years or five years,” he added.
Professor Mamas and his fellow researchers argue that the clinical outcomes of a study could be hugely important.
He said: “For many patients that have cancer, we always think about screening for cardiovascular disease in them. There are pathways now, clear guidelines, but there is not really in patients with cardiovascular disease. There are no written risk tools or pathways.”
He continued: “I think this paper is impactful in that it’s really making people think more closely that this is a circular relationship. It not just cancer patients have increased risk of cardiovascular disease, but patients with cardiac diseases have increased risk of.”
Prof Mamas suggested further research should help to define high risk groups amongst men and women with CVD and the cancer they are most prone to develop in order to create standardised risk scores.
This way, screening and wider preventative measures may be brought into general treatment of cardiovascular disease to help patients avoid a later cancer diagnosis.
He said finally: “I think this work will really make people pause for thought.”
Reference
Thuemmler R J et al. Sex differences in cancer incidence and mortality in patients with cardiovascular disease: the European Prospective Investigation into Cancer-Norfolk study. European Heart Journal, 2026. ehag515
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