Cancer Risk in Patients with Manifest Vascular Disease : Effects of Smoking, Obesity and Metabolic Syndrome
Menée auprès de 6 172 patients présentant une maladie vasculaire (durée médiane de suivi : 5,5 ans), cette étude prospective évalue l'association entre le tabagisme, l'obésité ou la présence d'un syndrome métabolique et le risque de cancers (563 cas)
Background : Patients with vascular disease may be at increased risk of cancer due to shared risk factors and common pathogenesis. Methods : Patients with vascular disease (n=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 ratios (HRs) of cancer were estimated for smoking status, pack-years, BMI, waist circumference and visceral adipose tissue [VAT] and 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 1.19,95%CI1.10-1.29). Specifically, risk of lung cancer (SIR 1.56,95%CI1.31-1.83), as well as bladder cancer (SIR 1.60,95%CI1.11-2.24) and cancer of the lip, oral cavity or pharynx in men (SIR 1.51, 95%CI0.89-2.39), and colorectal (SIR 1.71,95%CI1.11-2.53) and kidney cancer (SIR 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: 1.37,95%CI1.05-1.73), whereas an increase in VAT was associated with higher breast cancer risk in women (HR 1.42,95%CI1.03-1.96). 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.