A behavioral risk factor surveillance study found that premature atherosclerotic cardiovascular disease (ASCVD) was associated with increased risk for cancer. These findings were published in the European Journal of Preventive Cardiology.

Data for this study were sourced from the Behavioral Risk Factor Surveillance System, which contacted 1,745,999 individuals living in the US by telephone between 2016 and 2019. Participants were surveyed about their medical status and provided their sociodemographic characteristics.

This study included data from 748,090 individuals, among whom 3.3% (n=28,522) reported a history of premature ASCVD. The ASCVD and control group participants differed significantly for all characteristics (all P £.04) except for marijuana use (P =.70) and heavy alcohol consumption (P =.46).

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The study authors highlighted the fact that individuals with premature ASCVD were more likely to be Black, to live in states that did not expand Medicaid, and to delay medical care due to financial constraints. They were also more likely to have hypertension, diabetes, chronic kidney disease, and obesity.

In the fully adjusted model, individuals with premature ASCVD were at increased risk for any cancer diagnosis (adjusted odds ratio [aOR], 2.08; 95% CI, 1.72-2.50; P <.01).

The risk for cancer was increased among men (aOR, 2.21; 95% CI, 1.64-2.97; P <.01) compared with women (aOR, 2.00; 95% CI, 1.58-2.53; P <.01) and among Hispanic individuals (aOR, 3.41; 95% CI, 1.82-6.41; P =.03) compared with White (aOR, 1.80; 95% CI, 1.44-2.24; P <.01) or Black (aOR, 1.62; 95% CI, 0.91-2.86; P =.10) individuals.

Stratified by cancer type, premature ASCVD was associated with increased risk for head and neck (aOR, 21.08; 95% CI, 4.86-91.43; P <.01), genitourinary (aOR, 18.64; 95% CI, 3.69-94.24; P <.01), and breast (aOR, 3.96; 95% CI, 1.51-10.35; P =.05) cancers. In the fully adjusted model, risk was not significantly increased for female or male genital tract, gastrointestinal, lung, or central nervous system cancers; lymphomas; melanomas; or other cancers.

This study had a cross-sectional design and did not assess causality of the association between premature ASCVD and cancers.

These data indicated that individuals with premature ASCVD were at increased risk for cancers, especially of the head and neck, genitourinary system, and breast. These findings may have important implications for risk prevention strategies of ASCVD and cancer.


Jain V, Al Rifai M, Brinzevich D, et al. Association of premature atherosclerotic cardiovascular disease with higher risk of cancer: a behavioral risk factor surveillance system study. Eur J Prev Cardiol. Published online May 31, 2021. doi:10.1093/eurjpc/zwab084