Abstract 2016: Prior Diagnosis Of An Abdominal Aortic Aneurysm Is Associated With An Elevated Risk Of Subsequent Cancer Diagnosis

Abstract

Background: Epidemiological and mechanistic evidence suggests a potential causal link between cardiovascular disease (CVD) and cancer. Abdominal aortic aneurysms (AAA), a prevalent form of CVD with distinct genetic and biological etiologies, lack clarity regarding cancer risk compared to other CVD types. We conducted a retrospective cohort study using the IBM MarketScan Research Database to investigate whether AAA individuals face an increased cancer risk independent of traditional shared risk factors. Methods: Enrolling individuals aged ≥18 with ≥36 months of continuous coverage between 2008 and 2020, we excluded those with potential Mendelian AAA etiologies, aortic aneurysms with nonspecific anatomic location, or pre-follow-up cancer diagnoses. A subgroup analysis was performed including individuals with Health Risk Assessment records that included smoking status and BMI. We compared three groups: 1) AAA, 2) non-AAA CVD, and 3) no-CVD. Results: The propensity score-matched cohort comprised 68,269 AAA, 136,538 non-AAA CVD, and 136,538 no-CVD individuals. The 5-year cumulative incidence of any cancer was 10.0% (9.7 - 10.3%) in AAA, 7.4% (7.2 - 7.6%) in non-AAA CVD, and 7.4% (7.2 - 7.5%) in no CVD. Time-dependent multivariable-adjusted Cox proportional hazards regression models revealed AAA patients had a higher cancer risk than non-AAA CVD (HR: 1.32; 95% CI: 1.28-1.37; p-value: <0.001) or no CVD (HR: 1.37; 95% CI: 1.32-1.44; p-value: <0.001). Results were consistent after excluding common smoking-related cancers and when adjusting for smoking status and BMI in a subgroup analysis. Conclusions: AAA patients may face a uniquely elevated cancer risk, warranting further mechanistic study and enhanced cancer screening investigations.