Study Links Advanced Heart And Kidney Disease To Increased Cancer Risk

A new study found that people with advanced heart, kidney and metabolic disease have an increased risk of cancer. The study was published in American Heart Association's peer-reviewed scientific journal Circulation: Population Health and Outcomes. Cardiovascular-kidney-metabolic (CKM) syndrome is a group of heart, kidney and metabolic diseases. This is a recently proposed framework which highlights the close relationship between cardiovascular, kidney, and metabolic disorders. It is known that individual CKM health issues, such as high blood sugar, high blood pressure, chronic kidney disease, and obesity, increase the risk of certain cancers. However, the link between CKM stage and the risk of incident cancer wasn't known, the authors say.

The researchers said that they aimed to investigate a longitudinal association in a large-scale, nationwide population. Hidehiro Kaneko, M.D., Ph.D., the study's lead author and associate professor in the department of cardiovascular medicine at the University of Tokyo in Japan, said, "The study findings suggest that it is important to consider not only cardiovascular disease risk, but also cancer risk in people with CKM syndrome."

Study Overview And Findings

CKM syndrome is divided into different stages, depending on severity. It can range from stage 0 which indicates no risk factor to stage 4 which indicates risks of cardiovascular disease such as heart attack, stroke or heart failure.

For the study, the researchers from the University of Tokyo studied the link between CKM syndrome and cancer and if the stage of CKM syndrome could shed light on someone's risk for cancer.

The team analysed national insurance claims data to determine the CKM syndrome stage for nearly 1.4 million people based on the framework in the American Heart Association's Cardiovascular-Kidney-Metabolic Health presidential advisory. Then, they followed the participants for nearly three and a half years, wherein they documented if there were any new cancer cases.

The researchers found the following results which revealed the risk of cancer.

• At Stage 1, there was a 3% higher risk of developing cancer
• At Stage 2, there was a 2% higher risk of developing cancer
• At Stage 3, there was a 25% higher risk of developing cancer
• At Stage 4, there was a 30% higher risk of developing cancer

Kaneko said, "CKM syndrome represents a complex interplay among the cardiovascular, kidney and metabolic systems, where dysfunction in one area may trigger or exacerbate dysfunction in others."

He added, "Dysfunction in each of these systems is independently associated with cancer risk due to shared risk factors. This study suggests that the accumulation of risk factors within the framework of CKM syndrome may contribute to the development of various types of cancer."

Tochukwu Okwuosa, D.O., who is director of cardio-oncology services at Rush University Medical Center in Chicago and the volunteer for American Heart Association, said, "We already know that cancer and its therapies can lead to cardiotoxicities and cardiovascular disease. The study highlights the bidirectional relationship and underscores the concept of reverse cardio-oncology where cardiovascular disease and its risk factors also increase cancer risk. Consequently, healthy lifestyle choices potentially impact both conditions that are the leading causes of death in the United States. For those with established cardiovascular risk, the CKM syndrome staging framework may be a useful tool to flag high risk individuals for potential cancer screenings and evaluations."

Study Limitations

The authors also acknowledged certain limitations of the study. The study was derived from a Japanese nationwide cohort and hence, it cannot be generalised for countries with different health care systems or demographic structures. This warrants a study based on a global setting.

The authors stated another limitation and said that "as an observational study, it is inherently limited in establishing causality, and the possibility of diagnostic bias-such as differential detection of cancer across CKM stages due to varying health care utilization-cannot be entirely excluded.

The researchers also say that a "median follow-up of 3.4 years may be insufficient to capture long-term cancer risk, particularly for cancers with long latency periods."

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