Association between coronary artery disease and incident cancer risk: a systematic review and meta-analysis of cohort studies

Hsin-Hao Chen; Yi-Chi Lo; Wei-Sheng Pan; Shu-Jung Liu; Tzu-Lin Yeh; Lawrence Yu-Min Liu

doi:10.7717/peerj.14922

Association between coronary artery disease and incident cancer risk: a systematic review and meta-analysis of cohort studies

PeerJ. 2023 Feb 23:11:e14922. doi: 10.7717/peerj.14922. eCollection 2023.

Authors

Hsin-Hao Chen^{1

2

3}, Yi-Chi Lo⁴, Wei-Sheng Pan⁴, Shu-Jung Liu⁵, Tzu-Lin Yeh^{1

6}, Lawrence Yu-Min Liu^{2

3

7}

Affiliations

¹ Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan.
² MacKay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan.
³ Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.
⁴ Department of Medical Education and Research, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan.
⁵ Department of Medical Library, MacKay Memorial Hospital, Tamsui Branch, New Taipei City, Taiwan.
⁶ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan.
⁷ Division of Cardiology, Department of Internal Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan.

Abstract

Objective: Coronary artery disease (CAD) and cancer are the two leading causes of death worldwide. Evidence suggests the existence of shared mechanisms for these two diseases. We aimed to conduct a systematic review and meta-analysis to investigateassociation between CAD and incident cancer risk.

Methods: We searched Cochrane, PubMed, and Embase from inception until October 20, 2021, without language restrictions. Observational cohort studies were used to investigate the association between CAD and incident cancer risk. Using random-effects models, the odds ratio (OR) and 95% confidence interval (CI) were calculated. We utilized subgroup and sensitivity analyses to determine the potential sources of heterogeneity and explore the association between CAD and specific cancers. This study was conducted under a pre-established, registered protocol on PROSPERO (CRD42022302507).

Results: We initially examined 8,533 articles, and included 14 cohort studies in our review, 11 of which were eligible for meta-analysis. Patients with CAD had significantly higher odds of cancer risk than those without CAD (OR = 1.15, 95% CI = [1.08-1.22], I² = 66%). Subgroup analysis revealed that the incident cancer risk was significantly higher in both sexes and patients with CAD with or without myocardial infarction. Sensitivity analysis revealed that the risk remained higher in patients with CAD even after >1 year of follow-up (OR = 1.23, 95% CI = [1.08-1.39], I² = 76%). Regarding the specific outcome, the incident risk for colorectal and lung cancers was significantly higher (OR = 1.06, 95% CI = [1.03-1.10], I² = 10%, and OR = 1.36, 95% CI = [1.15-1.60], I² = 90%, respectively) and that for breast cancer was lower (OR = 0.86, 95% CI = [0.77-0.97], I² = 57%) in patients with CAD than in those without CAD.

Conclusion: CAD may be associated with incident cancer risk, particularly for lung and colorectal cancers, in men and women as well as patients with or without myocardial infarction. Early detection of new-onset cancer and detailed cancer surveillance programs should be implemented in patients with CAD to reduce cancer-related morbidity and mortality.

Keywords: Cancer; Cohort; Coronary artery disease; Meta-analysis; Systematic review.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Cohort Studies
Coronary Artery Disease* / epidemiology
Female
Humans
Male
Myocardial Infarction*
Neoplasms* / epidemiology

Grants and funding

The authors received no funding for this work.