Atrial Fibrillation and Risk of Cancer: A Danish Population‐Based Cohort Study

Abstract

BackgroundAtrial fibrillation (AF) and cancer are frequent diseases worldwide. The timewise association between the diagnosis of AF and a subsequent diagnosis of cancer may clarify whether a mutual cause exists, and may also guide clinicians about time windows of high risk of cancer occurrence.Methods and ResultsWe conducted a population‐based cohort study among 26 222 men and 28 879 women free of AF and cancer at baseline based on the Danish Diet, Cancer and Health study. The participants were followed for the development of AF (the Danish National Patient Registry) and subsequent cancer (the Danish Cancer Registry) until 2013. We used Cox proportional hazard models with new‐onset AF as time‐dependent exposure. The men (median age 56 years) and women (median age 56 years) were followed for medians of 16.7 and 19.6 years, respectively. AF was associated with higher risks of any type of cancer (men: hazard ratio [HR] 1.41, 95% confidence interval [CI], 1.26–1.58; women: HR 1.15, 95% CI, 1.02–1.32), and for men only, lung (HR 1.66, 95% CI, 1.19–2.30), and colorectal cancer (HR 1.37, 95% CI, 1.02–1.85). Within the initial 90 days following the diagnosis of AF, the risks of any type of cancer (men: HR 2.89, 95% CI, 2.10–3.98; women: HR 3.72, 95% CI, 2.49–5.56), lung (men: HR 7.70, 95% CI, 4.34–13.68; women: HR 7.98, 95% CI, 3.96–16.09), and colorectal cancer (men: HR 3.35, 95% CI, 1.03–10.90; women: HR 5.91, 95% CI, 2.44–14.29) were higher for men and women.ConclusionsA diagnosis of AF is associated with a higher incidence rate of cancer among men and women. The cancer incidence rate is particularly elevated within 90 days after the diagnosis of AF.

The interplay between host genetics and the gut microbiome reveals common and distinct microbiome features for complex human diseases

“…We provided an approach to interpret the data from mechanistic studies based on the microbiome. The microbiome features revealed a close association of AF with neurodegenerative diseases as well as cancers, which was supported by prior studies showing that AF had a correlation with AD and PD [40,41], and AF patients had relatively higher risks of several cancers, including lung cancer and CRC [42,50]. We also observed that the microbiome features of SLE and CML were highly similar.…”

The interplay between host genetics and the gut microbiome reveals common and distinct microbiome features for human complex diseases

“…We provide an approach to interpret the data from mechanistic studies based on microbiome. The microbiome features revealed a close association of AF with neurodegenerative diseases as well as cancers, which was supported by prior studies showing that AF had correlation with AD and PD 52, 53 , and AF patients had relatively higher risks of several cancers including lung cancer and CRC 54, 64 . We also observed that microbiome features of SLE and CML were highly similar.…”

The association of new-onset atrial fibrillation and risk of cancer: A systematic review and meta-analysis

“…Frequent visits to the medical system for AF would increase the chance of early detection of cancer. Vinter et al 13 reported that NOAF is closely associated with metastatic cancer within 90 days in the same year, further supporting the concept that patients with NOAF may be accompanied by occult cancers. (2) Atrial natriuretic peptide (ANP) related to AF has been shown to have extensive anti-proliferative effects, and might account for the significant reduction in cancer incidence after 90 days.…”

“…Six published observational articles were incorporated into the present analysis. [9][10][11][12][13][14] The integrated result demonstrated that patients with NOAF have a 24% increased risk of developing cancer. The subgroup analysis stratified by time interval, gender and type of cancer revealed the following: (1) the incident cancer significantly increased within 90 days after NOAF diagnosis, but not after that; (2) males appeared to have a higher risk, when compared to females; (3) the risk of lung cancer, but not colorectal cancer or breast cancer, was higher in patients with NOAF, when compared to non-AF patients.…”