Associations Between Cancer and Atrial Fibrillation: The Atherosclerosis Risk in Communities Study

Year: 2025

Type: article

Abstract: Objective: To evaluate temporal associations of cancer with subsequent incident atrial fibrillation (AF) and temporal associations of AF with subsequent incident cancer, within 3, 3 to 12, and >12 months after index diagnosis. Patients and Methods: We included 13,748 community-dwelling adults (mean age, 54 years) in the Atherosclerosis Risk in Communities study without cancer or AF histories at baseline (follow-up between January 1, 1987, and December 31, 2019). Atrial fibrillation was ascertained from electrocardiograms at study visits and health records. Cancer was ascertained via linkage with state registries and health records. We estimated associations of cancer with AF risk and AF with cancer risk by time since diagnosis using Cox regression, adjusting for shared risk factors and other cardiovascular diseases. Results: In 3909 adults, cancer was diagnosed before AF. Atrial fibrillation risk was the highest within 3 months after cancer diagnosis (hazard ratio [HR], 11.71; 95% CI, 9.52-14.41), followed by 3 to 12 months (HR, 2.07; 95% CI, 1.54-2.80) and >12 months (HR, 1.46; 95% CI, 1.29-1.64). In 1973 adults, AF was diagnosed before cancer. Cancer risk was the highest within 3 months of AF diagnosis (HR, 2.24; 95% CI, 1.47-3.41), followed by 3 to 12 months (HR, 1.28; 95% CI, 0.91-1.80) and >12 months (HR, 1.09; 95% CI, 0.91-1.29). Conclusion: In adult cancer patients, AF risk is the highest within 3 months after diagnosis and remains significantly elevated throughout survivorship but could be due to detection bias. Cancer risk is strongest within 3 months of AF diagnosis but significantly attenuated over time, suggesting detection bias and reverse causation.

Source: Mayo Clinic Proceedings Innovations Quality & Outcomes

DOI: 10.1016/j.mayocpiqo.2025.100634

Authors: Romil R. Parikh, Chetan Shenoy, Jeffrey R. Misialek, Anne Blaes, Faye L. Norby, Anna E. Prizment, Elsayed Z. Soliman, Laura R. Loehr, Alvaro Alonso, Corinne E. Joshu, Elizabeth A. Platz, Lin Yee Chen

Institutions: University of Minnesota, Wake Forest University Health Sciences, Wake Forest University, University of North Carolina at Chapel Hill, Emory University, Johns Hopkins University, Sidney Kimmel Comprehensive Cancer Center

Language: English

Topic: Atrial Fibrillation Management and Outcomes

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,000

Funders: U.S. Department of Health and Human Services, Emory University, University of Minnesota, Johns Hopkins University, National Institutes of Health, Centers for Disease Control and Prevention, Gillings School of Public Health, University of North Carolina at Chapel Hill, Johns Hopkins Bloomberg School of Public Health, Wake Forest School of Medicine, Sidney Kimmel Comprehensive Cancer Center, National Institute on Aging, National Heart, Lung, and Blood Institute, National Cancer Institute, National Institute of Neurological Disorders and Stroke, Division of Cancer Epidemiology and Genetics, National Cancer Institute

OpenAlex ID: W4411198504