Key result
Modifiable risk factors account for up to ~52% of cardiovascular mortality, far exceeding cancer mortality.
Why the study?
Cardiovascular disease and cancer are the leading causes of death worldwide, with a substantial proportion attributable to modifiable risk factors. This study aimed to assess the associations of modifiable risk factors with cardiovascular and cancer mortality across European and Asian populations.
Cohort (n=798,867)
Yes
Modifiable risk factors—particularly systolic blood pressure and diabetes for cardiovascular disease, and smoking for cancer—account for a substantially larger proportion of cardiovascular than cancer mortality across European and Asian populations, with marked sex and regional variations.
Answers are grounded in this paper and cite their sources.
Supports prioritizing blood pressure, diabetes, and smoking control to curb cardiovascular deaths more than cancer; extends multicohort evidence while leaving region-specific strategies open.
Background Cardiovascular disease and cancer are the leading causes of death worldwide, and a substantial proportion of mortality is attributable to modifiable risk factors. This study aimed to assess the associations of modifiable risk factors with cardiovascular and cancer mortality across European and Asian populations. Methods We analysed harmonized data from 798,867 adults in 25 cohorts across Europe, Western Asia and North Africa, and Central, East and South Asia, using two-stage random-effects individual-participant-data meta-analysis Cox and Weibull models to estimate hazard ratios and population-attributable fractions (PAFs). PAFs were estimated for each individual risk factor and jointly for all risk factors. Risk factors included body mass index, systolic blood pressure, non–HDL cholesterol, current smoking, and diabetes. The main outcomes were 10-year risks for cardiovascular and cancer mortality. Findings During a median follow-up of 8.2 years, 12,429 cardiovascular and 19,674 cancer deaths occurred. Deaths per 1000 person-years were higher among men for cardiovascular mortality (2.4, 95% CI 2.3–2.4) than women (1.4, 95% CI 1.4–1.5), as was cancer mortality (for men 3.6, 95% CI 3.5–3.7; for women 2.3, 95% CI 2.4–2.5). Joint PAFs were larger for cardiovascular than cancer mortality for women (52.3%, 95% CI 41.9–62.7, vs. 16.3%, 6.0–26.6) and men (44.4%, 95% CI 33.8–54.9, vs. 29.3%, 20.0–38.7) across regions. Systolic blood pressure and diabetes contributed most to cardiovascular mortality, while smoking was the main driver of cancer mortality, particularly in men. For cardiovascular mortality, joint PAFs were lowest in European men (37.5%, 95% CI 24.1–50.9) and highest in Western Asian and North African women (61.0%, 95% CI 51.7–70.3). For cancer mortality, joint PAFs were lowest in European women (14.7%, 95% CI 3.8–25.6) and highest in Central, East and South Asian men (34.5%, 95% CI 25.7–43.3). Interpretation Modifiable risk factors accounted for a larger proportion of cardiovascular than cancer deaths, with variations by sex and region. Prioritizing interventions for blood pressure, diabetes, and tobacco cessation could reduce mortality and improve region-specific prevention.
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Moghaddam et al. (2026) conducted a cohort in Cardiovascular and cancer mortality (n=798,867). Modifiable risk factors (body mass index, systolic blood pressure, non-HDL cholesterol, current smoking, and diabetes) was evaluated on 10-year risks for cardiovascular and cancer mortality (PAF 52.3% (women CV mortality), 95% CI 41.9-62.7). Modifiable risk factors accounted for larger joint PAFs in cardiovascular vs cancer mortality in women (52.3% vs 16.3%) and men (44.4% vs 29.3%).
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