2900 - American Heart Association Cardiovascular Health Metrics and Cancer Outcomes: A Systematic Review and Meta-Analysis
Presenter(s)
J. Torres1,2, S. Navarro3, H. Gao3, M. R. Wehner4,5, E. Hawk6, N. Leeper3, and K. T. Nead7; 1University of Texas Rio Grande Valley School of Medicine, Harlingen, TX, 2University of Texas MD Anderson Cancer Center, Houston, TX, 3Department of Vascular Surgery, Stanford University School of Medicine, Stanford, CA, 4Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, 5Department of Dermatology, The University of Texas MD Anderson Cancer, Houston, TX, 6Department of Cancer Prev & Pop Science, University of Texas MD Anderson Cancer Center, Houston, TX, 7Department of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
Purpose/Objective(s): Cardiovascular disease (CVD) and cancer have numerous shared risk factors. Additionally, preclinical models suggest CVD may directly impact the development and subsequent spread of cancer via circulating factors and immune changes. Therefore, CVD, and cardiovascular health (CVH) broadly, may directly and indirectly impact cancer risk and outcomes. Our objective is to conduct a systematic review and meta-analysis to determine whether American Heart Association (AHA) CVH metrics are associated with cancer outcomes. We hypothesize that better CVH scores are associated with lower cancer risk and cancer mortality.
Materials/Methods: We conducted systematic searches in PubMed and Scopus (inception to July 15, 2025). Cohort studies examining the association of AHA CVH metrics with cancer risk and cancer mortality were included. Study screening and data extraction were completed independently by two or more reviewers. We conducted random-effects meta-analyses to generate summary risk ratios (RRs) and standard errors (SEs) for outcomes with at least three contributing studies reporting low (worst), moderate, and high (best) CVH score groups. We utilized meta regression to examine dose-response relationships of CVH score groups.
Results: Our systematic review included 26 studies. Moderate (RR, 0.85; 95% CI, 0.79- 0.91, p<0.001) and high (RR, 0.72; 95% CI, 0.64-0.81, p<0.001) CVH scores groups were independently associated with lower overall cancer risk. We observed evidence of a dose-response effect (coefficient, -0.09; SE 0.02; p<0.001). High CVH scores were associated with a statistically significant lower risk of breast (RR, 0.72; 95% CI 0.58-0.90), colorectal (RR, 0.65, 95% CI 0.57-0.74), and lung cancer (RR, 0.34; 95% CI 0.16-0.70). Meta regression demonstrated a dose-response effect by CVH score group for lung (coefficient, -0.22; SE, 0.09; p=0.0014) and colorectal cancer (coefficient, -0.24; SE, 0.08; p=0.002). Additionally, we found evidence for lower cancer mortality in the moderate (RR, 0.64; 95% CI, 0.61-0.68, p<0.001) and high (RR, 0.47; 95% CI, 0.41-0.53, p<0.001) CVH groups. Meta regression also demonstrated evidence of a dose-response effect on all cancer mortality (coefficient, -0.33; SE 0.05; p<0.001).
Conclusion: We found that better AHA CVH metrics are associated with decreased cancer incidence and mortality, with a consistent dose-response effect. We support direct associations between CVH metrics and risk of breast, lung, and colorectal cancer, with the largest decreased risk in the high CVH score group. Our observed associations with breast and colorectal cancer emphasizes the importance of meta-analytic synthesis, as individual studies show inconsistent results. This study supports an association between better CVH and decreased cancer risk and cancer mortality. Novel approaches, including public health, clinical, and personal, could be considered to improve CVH to prevent cancer diagnosis and cancer-related death.