Abstract
BackgroundAn association between atrial fibrillation (AF) and risk of cancer has been suggested in several studies, including prospective cohort studies. However, the magnitude and the temporal nature of this association remain unclear.MethodsData from two large prospective population-based case-control studies, the Molecular Epidemiology of Colorectal Cancer (MECC, n = 8,383) and the Breast Cancer in Northern Israel Study (BCINIS, n = 11,608), were used to better understand the nature and temporality of a possible association between cancer diagnosis and AF events before and after cancer diagnosis. A case-control study approach was employed to study prior AF as a risk factor for cancer, and a cohort study approach was employed to study incident cancer as a risk factor for AF.ResultsAF was associated with a significant reduced odds of cancer as reflected in the case-control approach, with an adjusted OR = 0.77 (95% CI, 0.65–0.91), while cancer was not found to be significantly associated with elevated risk of AF in the cohort approach, with an adjusted HR = 1.10 (0.98–1.23). The immediate period (90 days) after an AF event was associated with a 1.85 times increased risk of cancer, and the immediate period after the diagnosis of cancer was associated with a 3.4 fold increased risk of AF. These findings probably reflect both the effect of acute transient conditions associated with new cancer diagnosis and detection bias. Similar results were identified with colorectal and breast cancer cases.ConclusionsAtrial fibrillation of longer than 90 days duration is associated with reduced odds of new cancer diagnosis. The results of this study suggest that an association observed in prior research may be due to instances related to cancer diagnosis and detection bias rather than a causal relationship. However, there may be bias in the sampling and residual confounding that distort the associations.
Highlights
Atrial fibrillation (AF) is a common cardiac arrhythmia that has been associated with increased risk of congestive heart failure, stroke and thromboembolism and increased mortality [1,2]
atrial fibrillation (AF) was associated with a significant reduced odds of cancer as reflected in the case-control approach, with an adjusted OR = 0.77, while cancer was not found to be significantly associated with elevated risk of AF in the cohort approach, with an adjusted HR = 1.10 (0.98–1.23)
Atrial fibrillation of longer than 90 days duration is associated with reduced odds of new cancer diagnosis
Summary
Atrial fibrillation (AF) is a common cardiac arrhythmia that has been associated with increased risk of congestive heart failure, stroke and thromboembolism and increased mortality [1,2]. The temporal nature of the association cannot be determined from cross-sectional studies, it has been suggested that cancer could promote the development of AF. A case-control study from Denmark and the Women’s Health Study (WHS) showed that cancer is a significant risk factor for AF [10,11]. These studies showed that the risk of AF is increased in the first 90 days after cancer diagnosis, but not thereafter [10,11], suggesting that acute transient conditions associated with new cancer diagnosis, such as surgery and cancer related complications may contribute to the development of AF. The magnitude and the temporal nature of this association remain unclear.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
