A new, independent study published today in the Journal of the American Heart Association reveals that alcohol use and smoking are linked to higher rates of both breast cancer and atrial fibrillation (AFib) in women aged 55 and older across multiple regions worldwide. The research, which analyzed data from 204 countries and territories, found that in about 40% of these regions, the incidence rates of breast cancer and atrial fibrillation were similar among older women, with the highest-risk zones concentrated in Western nations.
The study, led by researchers at Peking University People's Hospital in Beijing, evaluated exposure to 58 shared and distinct risk factors, including smoking, alcohol use, body mass index, and physical activity. After accounting for multiple variables, smoking and alcohol use were significantly associated with higher rates of both conditions. An additional analysis suggested that reducing alcohol intake and smoking could potentially lower the risk of breast cancer by about 15% and the risk of atrial fibrillation by about 12% worldwide.
“Identifying shared risk factors is important for developing interventions that support optimal health, such as smoking cessation and alcohol restriction, which could potentially reduce the global incidence of breast cancer and atrial fibrillation/flutter substantially,” said study co-author Shu Wang, M.D., Ph.D., director of the Breast Disease Center at Peking University People’s Hospital.
The research noted that 80 countries or territories (39%) had similar rates of both breast cancer and atrial fibrillation. About 65 countries (32%) were breast cancer-dominant, and 57 countries (28%) were atrial fibrillation-dominant. High-income and developed nations, such as the U.S., Canada, Australia, New Zealand, and much of Europe, exhibited elevated rates of both conditions, aligning with previous research linking Western diets and sedentary lifestyles to increased risks.
“One of the most surprising aspects of our findings was how common both breast cancer and atrial fibrillation/flutter diagnoses were among women ages 55 and older in high-income regions, which highlights the influence of lifestyle,” Wang said. “This is the first study combining global data with machine learning to show the relationship between the conditions, their location across the world and the shared risk factors of these two conditions.”
Co-authors Zeye Liu, M.D., Ph.D., and Yi Shi, M.D., Ph.D., both from Peking University People’s Hospital, emphasized the importance of these findings. “Nowadays, more and more people are paying attention to the link between cancer and cardiovascular health. Breast cancer and atrial fibrillation/flutter rise together across many regions of the world and share the same modifiable risk factors. From a cardiovascular perspective, this means that reducing smoking and alcohol use could help lower the risk of both conditions at the same time.”
The study’s results align with a 2018 Scientific Statement from the American Heart Association, which identified that breast cancer and cardiovascular disease share common risk factors that may be prevented through lifestyle modifications. Laxmi Mehta, M.D., FAHA, chair of the American Heart Association’s Council on Clinical Cardiology, who was not involved in the study, noted, “Many of the same modifiable factors—including smoking, alcohol use, poor diet, physical inactivity and obesity—contribute to both breast cancer and cardiovascular disease including atrial fibrillation/flutter, as confirmed by this study’s findings. This overlap underscores the importance of integrated lifestyle strategies to reduce risk of cardiovascular disease and cancer.”
The newly developed spatial risk maps from this study can help guide region-specific prevention strategies. According to the researchers, the next step will be to incorporate long-term research, genetic and metabolic data, as well as socioeconomic factors, into the analysis to develop individualized prevention strategies.
The study utilized data from the Global Burden of Disease 2021 database and focused on women aged 55 and older in 204 countries. Limitations include the lack of individual-level data and potential variations in data collection and screening across countries. The full study is available in the Journal of the American Heart Association, and more information on atrial fibrillation can be found at the American Heart Association’s What is Atrial Fibrillation? page.
