ADULT HEALTH – Results of a recent Danish study suggest that patients who survive a myocardial infarction (MI or heart attack) may be at significant risk for overall and specific types of cancer.
However, the study was not designed to establish whether the significant association found between prior MI and cancer could be due to the patient’s smoking status. Lifestyle data on smoking was not included in the study.
“We saw an especially increased risk within the first 6 months of having an MI. But even after that, there was still an increased risk of cancer, especially in the lungs and bladder. Future studies could include lifestyle data on smoking, among others ,” said lead author Morten Winther Malmborg of Gentofte Hospital, University of Copenhagen, Denmark.
The study examined nationwide data from Danish registries for almost 126,000 MI survivors without a history of cancer and more than three million individuals with no history of either MI or cancer. Results showed an incidence rate (IR) for any cancer of 173.5 per 10,000 person-years for the MI survivors after up to 17 years of follow-up compared to an IR of 85.2 per 10,000 person-years for their healthy peers.
The highest relative risks for developing cancer were found during the first month following an MI. The risk then decreased steadily but stayed at a “constant rate” 6 months after the heart attack. The youngest age group (between 30 and 54 years) had the highest association between MI history and increased cancer risk after the 6-month mark.
The investigators underscored the need to focus on cancer in MI survivors. They believe that the results of their study have potential implications on future patient care, outpatient follow-up strategies, and distribution of healthcare resources.
Heart attack, cancer among top killers of Filipinos
According to World Health Organization (WHO) estimates, non-communicable diseases (NCDs) such as heart attack and cancers accounted for 67% of total deaths in the Philippines in 2012. Cardiovascular diseases including MI accounted for 33% of total deaths in the country for that year while cancers accounted for 10%.
The “2010 Philippine Cancer Facts and Estimates”found that…[pq]…the most common forms of cancer among Filipinos are cancer of the lung, breast, cervix, liver, colon and rectum, prostate, stomach, mouth, ovary and leukemia.[/pq]
It is interesting to note that heart attack and cancer have many risk factors in common.
Heart attack risk factors
Certain factors contribute to atherosclerosis, the unwanted buildup of fatty deposits that narrows arteries throughout the body, including the arteries of the heart (coronary arteries). Heart attack risk factors include:
- Age – men age 45 or older and women age 55 or older are at increased risk
- Smoking and long-term exposure to secondhand smoke – the 2009 Philippines Global Adult Tobacco Survey (GATS) revealed that almost 1 in 3 Filipinos (28.3%) aged 15 years old and over are smokers, and almost half (47.7%) of smokers in the country are men.
- High blood pressure – a nationwide survey conducted by the Philippine Heart Association in 2013 found that 1 in 4 adult Filipinos (28%) are hypertensive
- High blood cholesterol or triglyceride levels (dyslipidemia) – the National Nutrition and Health Survey II (NNHeS II) conducted by the Food and Nutrition Research Institute (FNRI) and University of the Philippines-College of Medicine in 2008 found a dyslipidemia prevalence of 72%.
- Diabetes – NNHeS II revealed a prevalence of diabetes of 4% on the basis of fasting blood glucose (FBG), 5% by FBG and history, and 6% based on 2-hour post-prandial plasma glucose
- Family history of heart attack
- Lack of physical activity
- Obesity – NNHeS II revealed a prevalence of obesity of 4.9% based on body mass index (BMI), and 10.2% and 65.6% based on waist-hip ratio (WHR) in men and women, respectively.
- Illegal drug use, such as cocaine or amphetamines including “shabu”
- History of preeclampsia, a condition that causes high blood pressure during pregnancy
- History of an autoimmune condition, such as rheumatoid arthritis or lupus.
Cancer risk factors
One in three cancer deaths are due to the five leading behavioral and dietary risk factors:
- Excess weight
- Low fruit and vegetable intake
- Lack of physical activity
- Tobacco use
- Alcohol intake
– Eric Michael Santos, Medical Observer