People with advanced heart, kidney and metabolic disease may face a higher risk of developing cancer, according to new research published today in the American Heart Association’s peer-reviewed scientific journal Circulation: Population Health and Outcomes. The study, which analyzed data from nearly 1.4 million adults in Japan, found that individuals in later stages of cardiovascular-kidney-metabolic (CKM) syndrome had a 25% to 30% higher risk of cancer compared to those with no risk factors.
CKM syndrome refers to the interconnected conditions of heart disease, kidney disease, diabetes, and obesity. According to the American Heart Association, nearly 9 out of 10 adults in the U.S. have at least one component of CKM syndrome, such as high blood pressure, abnormal cholesterol, high blood glucose, excess weight, or reduced kidney function. The syndrome is staged from 0 (no risk factors) to 4 (established cardiovascular disease like heart attack or stroke).
Researchers at the University of Tokyo reviewed national insurance claims data to classify participants by CKM stage based on the framework in the American Heart Association's Cardiovascular-Kidney-Metabolic Health presidential advisory. Over a follow-up period of about 3.5 years, new cancer diagnoses were recorded. The results showed that cancer risk was only modestly elevated in early stages (stage 1: 3% higher; stage 2: 2% higher) but jumped sharply in later stages (stage 3: 25% higher; stage 4: 30% higher).
“The study findings suggest that it is important to consider not only cardiovascular disease risk, but also cancer risk in people with CKM syndrome,” said lead author Hidehiro Kaneko, M.D., Ph.D., associate professor at the University of Tokyo. Kaneko noted that dysfunction in the cardiovascular, kidney, and metabolic systems may independently contribute to cancer risk due to shared factors, and the accumulation of risk factors within CKM syndrome could promote cancer development.
Tochukwu Okwuosa, D.O., director of cardio-oncology services at Rush University Medical Center and an American Heart Association volunteer, highlighted the bidirectional relationship between heart disease and cancer. “We already know that cancer and its therapies can lead to cardiotoxicities and cardiovascular disease. The study highlights the bidirectional relationship and underscores the concept of reverse cardio-oncology where cardiovascular disease and its risk factors also increase cancer risk,” she said. Okwuosa added that the CKM staging framework could help flag high-risk individuals for cancer screenings.
A limitation of the study is that it was conducted in a Japanese population, which may not be fully generalizable. However, the authors noted that other studies have consistently found links between metabolic and kidney dysfunction and increased cancer risk, suggesting the findings likely apply elsewhere.
The implications of this research are significant: as CKM syndrome becomes more prevalent, healthcare providers may need to integrate cancer risk assessment into routine care for patients with advanced stages. The study underscores the importance of addressing shared risk factors through lifestyle changes and medical management to potentially reduce the burden of both cardiovascular disease and cancer, which are leading causes of death in the United States.
