heart failure patients may face an increased risk of a range of different cancers, according to a massive new study that stresses the importance of regular screenings for the high-risk group.the study,
published in the journal esc heart failure, tracked 100,124 heart-failure patients in a german health database and compared them to the same number of individuals who did not suffer from the progressive, chronic condition. none of the participants had cancer at the beginning of the 10-year window of observation,
according to the new york times. while the study controlled for age, sex,
obesity and presence of
diabetes, data was unavailable for a few other major risk factors, including socioeconomic status, smoking, alcohol consumption and physical activity.
by the end of the study, 25.7 per cent of heart failure patients — who can live for years with the condition — had developed some form of cancer, compared to just 16.2 per cent in the control group. the large nature of the study allowed researchers to contrast specific cancers: the heart failure group faced an increased risk of lung and other respiratory cancers (91 per cent greater), skin cancers (83 per cent) and colon, stomach and other cancers of the digestive system (75 per cent). the heart failure group also had double the risk of cancers of the lip, oral cavity and pharynx. women with heart failure faced an increased risk of genital cancers (86 per cent) and
breast cancer (67 per cent), and men had higher odds of genital cancer (52 per cent).“i think it is an interesting retrospective cohort study,” said girish l. kalra, a senior cardiology fellow at the david geffen school of medicine at ucla, who did not participate in the research. “the primary shortcoming of the study is that the database did not allow investigators to control for the single greatest risk for developing cancer and heart disease: smoking. cigarette smoking may be the common thread in this study.”while the absence of data on smoking habits may account for an increase in oropharyngeal and respiratory cancers, the increased risk was evident across a spectrum of different cancers. beyond smoking, there are other factors that can account for the link between heart failure and cancer, researchers said, including previous research that concluded a protein biomarker of heart disease correlates to a heightened cancer risk. they also speculated that chronic inflammation may at play in both cancer and heart failure cases.“there are more correlations between heart failure and cancer than just common risk factors,” said mark luedde, senior author of the study and a cardiologist at the university of kiel in germany. “heart failure is not a disease of the heart. it is almost always a disease of the heart and other organs. the importance of co-morbidities for the prognosis and quality of life of those affected cannot be overestimated.”the study highlights the unique risks heart failure patients face and the importance of timely medical care.“ultimately, the heart is a bellwether for all health,” karla said. “this study supports the notion that people with heart failure are a high-risk group and warrant our closest attention. as physicians, we should make sure that our cardiac patients are getting screened for cancer at the recommended time intervals.“and we should continue to nag our smokers to quit.”
dave yasvinski is a writer with healthing.ca
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