Key result
Cancer was associated with less atherosclerosis postmortem (OR 0.60, p<0.0001), with the strongest inverse associations in non-smoking-related cancers, haematological neoplasms, and sarcomas.
Why the study?
Is cancer associated with the grade of atherosclerosis in an autopsy cohort?
Cohort (n=2,101)
Is cancer associated with the grade of atherosclerosis in an autopsy cohort?
Cancer, particularly non-smoking-related types, is inversely associated with the severity of atherosclerosis at autopsy, suggesting potential shared or divergent pathomechanisms or effects of chemotherapy.
Does not support altering atherosclerosis screening or therapy by cancer status; leaves open mechanisms and causality for prospective study.
AIMS: Atherosclerosis and cancer share common risk factors and involve similar molecular pathomechanisms. Most clinical and epidemiological studies show a positive correlation between atherosclerosis and smoking-related cancers and heterogeneous results for non-smoking-related cancers. However, up-to-date large-scale autopsy studies including a detailed analysis of cancer types are lacking. Therefore, we sought to investigate the relation between major cancer types and the grade of atherosclerosis in a recent well-powered autopsy cohort. METHODS: In 2101 patients, both autopsy data and clinical data including demographics, disease groups, tumour type, cause of death and grade of atherosclerosis were reviewed and statistically analysed. RESULTS: We found cancer in general is associated with less atherosclerosis (OR 0.60, p<0.0001). In particular, haematological neoplasm and sarcomas were associated with much less atherosclerosis (OR=0.45, p<0.0001 and OR=0.43, p=0.087), while carcinomas were associated with moderately less atherosclerosis (OR=0.72, p=0.002). Furthermore, non-smoking-related cancers were associated with much less atherosclerosis (OR=0.41, p<0.0001), while possibly smoking-related cancer and smoking-related cancer showed no significant association. In a comprehensive analysis of 21 cancer types, biliary tract cancer, lymphomas/lymphoid leukaemias and kidney cancer were associated with much less atherosclerosis (OR=0.19, p<0.0001; OR=0.41, p<0.0001; and OR=0.48, p=0.029). In an exploratory analysis of treatment strategies, we found that tumours with a recommendation of oxazaphosphorines and pyrimidine antagonist treatment were significantly associated with less atherosclerosis (OR=0.33, p=0.0068 and OR=0.58, p=0.012). CONCLUSIONS: In conclusion, the study showed an inverse association between cancer and atherosclerosis postmortem that depends on the cancer type and suggests a possible impact of chemotherapy regimens.
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Budczies et al. (2014) conducted a cohort in Cancer and atherosclerosis (n=2,101). Cancer vs. No cancer was evaluated on Grade of atherosclerosis (OR 0.60, p=<0.0001). Cancer was associated with less atherosclerosis postmortem (OR 0.60, p<0.0001), with the strongest inverse associations in non-smoking-related cancers, haematological neoplasms, and sarcomas.
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