Evaluating the shared risk factors between atherosclerotic cardiovascular disease and cancer: how significant is the link?

INTRODUCTION: Atherosclerotic cardiovascular disease (ASCVD) and cancer are the leading causes of death globally. While traditionally viewed as distinct, growing evidence reveals significant overlap in their risk factors and pathophysiology, suggesting a shared biological basis that warrants closer clinical and research attention. AREAS COVERED: This review explores modifiable lifestyle and pathological risk factors that contribute to both ASCVD and cancer, including tobacco use, poor diet, physical inactivity, environmental toxins, hypertension, hyperlipidemia, obesity, insulin resistance, and sex hormone dysregulation. Mechanistically, these factors converge on common pathways such as chronic inflammation, oxidative stress, and hormonal imbalance, facilitating both atherogenesis and tumorigenesis. The paper also highlights how these shared mechanisms offer opportunities for unified prevention and treatment strategies. EXPERT OPINION: Understanding these connections is critical for dual-risk stratification, prevention, and management strategies. Emerging approaches such as personalized medicine, leveraging genomic and biomarker data, and multidisciplinary care models that integrate cardiology and oncology expertise offer opportunities to optimize outcomes. Advances in multi-omics and targeted therapies promise to further elucidate the shared mechanisms, paving the way for innovative interventions. This comprehensive understanding highlights the need for integrated care to address the dual burden of ASCVD and cancer and improve patient outcomes.