Cancer Risk in Patients with Manifest Vascular Disease: Effects of Smoking, Obesity, and Metabolic Syndrome

Abstract

Background: Patients with vascular disease may be at increased risk of cancer because of shared risk factors and common pathogenesis.Methods: Patients with vascular disease (n ¼ 6,172) were prospectively followed for cancer incidence. Standardized incidence ratios (SIRs) were calculated to compare the cancer incidence of the study population with that of the general population. Multivariable-adjusted hazard ratio's (HRs) of cancer were estimated for smoking status, pack-years, body mass index, waist circumference and visceral adipose tissue (VAT), and metabolic syndrome (MetS).Results: During a median follow-up of 5.5 years, 563 patients were diagnosed with cancer. Patients with vascular disease were at increased risk of cancer [SIR ¼ 1.19; 95% confidence interval (CI), 1.10-1.29]. Specifically, risk of lung cancer (SIR ¼ 1.56; 95% CI, 1.31-1.83), as well as bladder cancer (SIR ¼ 1.60; 95% CI, 1.11-2.24) and cancer of the lip, oral cavity, or pharynx in men (SIR ¼ 1.51; 95% CI, 0.89-2.39), and colorectal (SIR ¼ 1.71; 95% CI, 1.11-2.53) and kidney cancer (SIR ¼ 2.92; 95% CI, 1.05-6.38) in women was increased. A relation between smoking and cancer risk was observed (HR for current smokers ¼ 1.37; 95% CI, 1.05-1.73), whereas an increase in VAT was associated with higher breast cancer risk in women (HR ¼ 1.42; 95% CI, 1.03-1.96). No relation between MetS and cancer risk was found.Conclusions: Patients with vascular disease have a 19% higher cancer risk compared to the general population. Smoking increased cancer risk and abdominal obesity is a risk factor for breast cancer in female patients with vascular disease.Impact: These results call for awareness of the increased cancer risk in patients with vascular disease among physicians and underline the necessity of lifestyle improvement not only for reducing cardiovascular risk. Cancer Epidemiol Biomarkers Prev; 22(7); 1267-77. Ó2013 AACR.

Estimated Life Expectancy Without Recurrent Cardiovascular Events in Patients With Vascular Disease: The SMART‐REACH Model

“…Because of shared risk factors, patients with cardiovascular risk are also at increased risk of other causes of death 25, 26. For example, smoking causes cardiovascular disease but also increases a patient's risk to die from cancer or chronic obstructive pulmonary disease.…”

Cancer Risk and Subsequent Survival after Hospitalization for Intermittent Claudication

“…Prior studies linking coronary heart disease and cerebrovascular disease to cancer risk point to an association primarily with smoking-related cancers, with inconsistent findings regarding a few nonsmoking-related cancers (6)(7)(8)(9)(10)(11). Previous research regarding the relation of intermittent claudication with risk of cancer is limited to one population-based cohort study from Sweden (9).…”

“…Myocardial infarction and cerebrovascular disease are strongly associated with cigarette smoking, which is also associated with cancer risk (9)(10)(11). Consequently, one explanation for the cancer associations of these vascular diseases is the shared risk factor of smoking.…”

“…Indeed, the excess cancer risk in individuals with myocardial infarction and cerebrovascular disease is largely limited to smoking-related cancers (4)(5)(6)(7)(8)(9)(10). An association between intermittent claudication and cancer risk has been shown in multiple studies, but with inconclusive results regarding whether the increased risk is limited to smoking-related malignancies (9)(10)(11). Also unknown is the mortality risk for patients with intermittent claudication who develop cancer in comparison with the prognosis for patients with cancer without an intermittent claudication history.…”

Enhancing the anti-colon cancer activity of quercetin by self-assembled micelles

“…2 The estimated number of new individuals diagnosed with colorectal tumor, including both men and women, will reach 136,830 in the US in 2014, and 50,310 patients will be killed by this carcinoma, 2,3 in part because of the risk factors, which include diet, obesity, sedentariness, lack of physical activity, smoking, alcohol intake, and so forth. [4][5][6][7][8] Although the pathogenesis and diagnostic techniques of colon tumor has been best understood, [9][10][11] a considerable percentage of this cancer is advanced carcinoma, typically metastasized and difficult to fully eradicate through surgery, when they are found. Consequently, plenty of chemotherapeutic agents are employed in the therapy of a variety of terminal cancers.…”