Faculty, Staff and Student Publications
Publication Date
7-1-2024
Journal
Arteriosclerosis, Thrombosis, and Vascular Biology
Abstract
Background: Epidemiological and mechanistic data support a potential causal link between cardiovascular disease (CVD) and cancer. Abdominal aortic aneurysms (AAAs) represent a common form of CVD with at least partially distinct genetic and biologic pathogenesis from other forms of CVD. The risk of cancer and how this risk differs compared with other forms of CVD, is unknown among AAA patients. We conducted a retrospective cohort study using the IBM MarketScan Research Database to test whether individuals with AAA have a higher cancer risk independent of traditional shared risk factors.
Methods: All individuals ≥18 years of age with ≥36 months of continuous coverage between 2008 and 2020 were enrolled. Those with potential Mendelian etiologies of AAA, aortic aneurysm with nonspecific anatomic location, or a cancer diagnosis before the start of follow-up were excluded. A subgroup analysis was performed of individuals having the Health Risk Assessment records including tobacco use and body mass index. The following groups of individuals were compared: (1) with AAA, (2) with non-AAA CVD, and (3) without any CVD.
Results: The propensity score-matched cohort included 58 993 individuals with AAA, 117 986 with non-AAA CVD, and 58 993 without CVD. The 5-year cumulative incidence of cancer was 13.1% (12.8%-13.5%) in participants with AAA, 10.1% (9.9%-10.3%) in participants with non-AAA CVD, and 9.6% (9.3%-9.9%) in participants without CVD. Multivariable-adjusted Cox proportional hazards regression models found that patients with AAA exhibited a higher cancer risk than either those with non-AAA CVD (hazard ratio, 1.28 [95% CI, 1.23-1.32]; P<0.001) or those without CVD (hazard ratio, 1.32 [95% CI, 1.26-1.38]; P<0.001). Results remained consistent after excluding common smoking-related cancers and when adjusting for tobacco use and body mass index.
Conclusions: Patients with AAA may have a unique risk of cancer requiring further mechanistic study and investigation of the role of enhanced cancer screening.
Keywords
Humans, Aortic Aneurysm, Abdominal, Male, Incidence, Female, Retrospective Studies, Middle Aged, Aged, Risk Factors, Neoplasms, Risk Assessment, United States, Time Factors, Databases, Factual, Adult, Aged, 80 and over, aortic aneurysm, biological products, risk assessment, smoking, tobacco use.
DOI
10.1161/ATVBAHA.123.320543
PMID
38779853
PMCID
PMC11209781
PubMedCentral® Posted Date
7-1-2025
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Included in
Bioinformatics Commons, Biomedical Informatics Commons, Cardiology Commons, Genetic Phenomena Commons, Medical Genetics Commons, Oncology Commons