The authors examined data from 104,020 HF patients 50 years old or older. All patients received care in Italy between 2002 and 2018. Sixty-one percent of the patients were men, and the median age was 76 years old.
In the analysis, the incidence rate (IR) of cancer was 21.36 per 1,000 person-years in patients with HF. Among a group of 104,020 controls, the IR was 12.42 per 1,000 person-years.
The number of deaths related to cancer was also higher in HF patients compared with the control group. For example, patients younger than 70 years old with HF had a nearly eight-fold increased risk of cancer mortality compared to those without HF.
A competing risk analysis verified the link between HF and cancer mortality.
Another key finding was that, although the IR of all types of cancer rose with age, the HF-related excess risk was steady across all age groups.
In addition, a prescription of high-dose loop diuretic was linked with elevated cancer rates in HF patients.
“This study supports the notion that HF does portend an increased risk of cancer, regardless of sex and age, although the incidence rate of cancer was markedly higher in males and increased with age,” wrote lead author Edoardo Bertero, of the Italian IRCCS Cardiology Network in Italy, and colleagues. “The cardiologist should be aware that cancer is a major comorbidity in HF, and close collaboration between cardiologists and oncologists is required to guide the optimal management of patients with both HF and cancer.”
The authors encouraged further studies to assess the prognostic impact of cancer in the HF population and to clarify potential mechanistic associations between HF and cancer.
The authors concluded that “HF is associated with an increased risk of cancer and cancer-related mortality, which may be heightened in decompensated states.”
