Akhmetzhan Galimzhanov, Elif Beytekin, Leh Chuan Lim, Abdul Basit Ali Zai, Gemina Doolub, Mustafa Aljarshawi, Balamrit Singh Sokhal, Andrija Matetic, Rodrigo Bagur, Louise Y Sun, Cheng Han Ng, Miguel Nobre Menezes, Sarah Zaman, Bonnie Ky, Mamas A Mamas
Cancer represents a substantial comorbidity across cardiovascular and cardiometabolic conditions. Although cancer ascertainment methods varied across studies, particularly for any cancer, the findings provide contemporary estimates of cancer burden that may inform future cardio-oncology research, healthcare planning, risk stratification, and the design of cardiovascular and cardiometabolic clinical trials.
BACKGROUND: To the best of our knowledge, no previous systematic review has comprehensively quantified cancer prevalence across the broad spectrum of cardiovascular and cardiometabolic conditions included in the present study. We aimed to estimate pooled prevalence of active cancer (primary outcome) and other cancer categories among patients with coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), hypertension, Type 2 diabetes mellitus (DM), stroke, peripheral artery disease (PAD), and valvular heart disease (VHD).
METHODS: PubMed, Web of Science, and Scopus were searched from 2010 to July 2024. Secondary outcomes included prevalence of any, previous, haematological, solid, and metastatic cancer. Prevalence estimates were calculated using one-step generalized linear mixed models.
RESULTS: A total of 676 studies comprising approximately 180 million participants were included. The primary analysis of active cancer included 59 studies (4,759,695 patients). Active cancer prevalence ranged from 4.22% (95% confidence interval [CI] 2.18-5.32) in Type 2 DM to 5.55% (95% CI 3.97-7.01) in AF. The prevalence of any cancer, a secondary outcome with more heterogeneous ascertainment, ranged from 7.04% (95% CI 6.05-8.03) in CAD to 14.10% (95% CI 12.20-15.99) in AF.
CONCLUSION: Cancer represents a substantial comorbidity across cardiovascular and cardiometabolic conditions. Although cancer ascertainment methods varied across studies, particularly for any cancer, the findings provide contemporary estimates of cancer burden that may inform future cardio-oncology research, healthcare planning, risk stratification, and the design of cardiovascular and cardiometabolic clinical trials.
TRIAL REGISTRATION: PROSPERO CRD42023494764.