An observational study involving more than 200,000 participants suggests heart failure patients have an increased risk of later developing any type of cancer, compared to those without the condition, according to findings presented June 28 at the European Society of Cardiology's 2021 heart failure congress.
The study, which pulled data from a national database in Germany that covers 1,274 general practices, included 100,124 patients with heart failure and the same number of patients without heart failure. At the start of the study period, no patients had cancer.
Researchers followed participants for 10 years and found cancer incidence was significantly higher among heart failure patients at nearly 26 percent, compared to 16.2 percent in those without heart failure.
Among women with heart failure, cancer incidence was 28.6 percent compared to 18.8 percent in those without heart failure. For men, the rates were 23.3 percent and 13.8 percent respectively.
Overall, the hazard ratio of developing cancer for patients with heart failure was 1.76. Cancer of the lip, oral cavity and pharynx were associated with the greatest risk increase, followed by respiratory organ cancer, findings showed.
While the findings don't prove heart failure directly causes cancer, "the findings do suggest that heart failure patients may benefit from cancer prevention measures," said Dr. Mark Luedde, study author and physician at the Christian-Albrechts-University of Kiel and Cardiology Joint Practice in Bremerhaven, Germany.
"Our results allow us to speculate that there may be a causal relationship between heart failure and an increased rate of cancer," Dr. Luedde said. "This is biologically plausible, as there is experimental evidence that factors secreted by the failing heart may stimulate tumour growth."
While it's well established that some cancer patients develop heart failure from the effects of treatment, there hasn't been as much research on whether heart failure is associated with cancer development.
"It is common practice for cancer patients who have received heart-damaging drugs to be monitored for heart failure," Dr. Luedde said. "Conversely, evidence is accumulating to indicate that heart failure patients could benefit from intensive monitoring for cancer development — for example through screening, considering the high incidence of both."
The findings were also published in ESC Heart Failure.