LONDON – Adult patients with chronic heart failure had an average 51% increased incidence of all forms of cancer, compared with the general population in an analysis of more than 9,000 Danish patients treated for heart failure during 2002-2009.
Although the study did not address causality, the elevated risk for new-onset cancers in heart failure patients may stem from shared risk factors for the two diseases, Dr. Ann Banke said at the annual congress of the European Society of Cardiology. Smoking, for example, is a potential etiologic factor for both heart failure and certain cancers. Other potential shared risk factors could include other types of unhealthy lifestyle choices, and a heightened inflammatory state, suggested Dr. Banke, a researcher in the department of cardiology at Odense (Denmark) University Hospital.
Mitchel L. Zoler/Frontline Medical News
Dr. Ann Banke
“Increased awareness of the risk for development of cancer in heart failure patients is warranted,” especially given the relatively long life expectancy now seen among many patients with chronic heart failure, Dr. Banke said.
She and her associates reviewed 9,307 Danish patients with chronic heart failure and no history of cancer who entered a national heart failure cohort during 2002-2009. Their average age was 68 years, 73% were men, 89% had heart failure with reduced ejection fraction, 80% had New York Heart Association class I or II heart failure, and 15% had diabetes. During follow-up through 2013, a total of 975 of these patients received a diagnosis of cancer. The researchers compared the incidence rate of cancer among these heart failure patients with the rate in the general Danish adult population in the same 2002-2013 period, during which the general population developed 330,843 cancers.
In an analysis that adjusted for age and sex, the heart failure patients had a statistically significant 51% increased rate of incidence cancers of all types (P less than .0001). When broken down by cancer site, the heart failure patients showed significantly increased rates for all types of cancers except prostate cancer (see chart). Dr. Banke speculated that the absence of an increased incidence rate in prostate cancer among heart failure patients may reflect the age of the heart failure patients, or perhaps because prostate cancer does not share as many risk factors with heart failure as do the other cancer types.
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