A new global analysis published today in the Journal of the American Heart Association finds that alcohol use and smoking are linked to both breast cancer and atrial fibrillation/flutter in women ages 55 and older across multiple regions of the world. The study, which examined data from 204 countries and territories, reveals that in about 40% of these regions, the rates of both conditions were similar, particularly in high-income Western nations.
Researchers evaluated 58 shared and distinct risk factors, including smoking, alcohol use, body mass index, and physical activity. After accounting for multiple variables, smoking and alcohol use were associated with higher rates of both breast cancer and atrial fibrillation/flutter. An additional analysis suggested that reducing alcohol intake and smoking could potentially reduce the risk of breast cancer by about 15% and the risk of atrial fibrillation/flutter by about 12% worldwide.
“Identifying shared risk factors is important for developing interventions that support optimal health, such as smoking cessation and alcohol restriction, which could potentially reduce the global incidence of breast cancer and atrial fibrillation/flutter substantially,” said study co-author Shu Wang, M.D., Ph.D., director of the Breast Disease Center at Peking University People’s Hospital in Beijing.
The study found that high-income and developed nations, such as the U.S., Canada, Australia, New Zealand, and much of Europe, exhibited elevated rates of both conditions, aligning with previous research linking Western diets and sedentary lifestyles to increased risks. “One of the most surprising aspects of our findings was how common both breast cancer and atrial fibrillation/flutter diagnoses were among women ages 55 and older in high-income regions, which highlights the influence of lifestyle,” Wang said.
According to the researchers, this is the first study to combine global data with machine learning to show the relationship between the conditions, their geographic distribution, and shared risk factors. The newly developed spatial risk maps can help guide region-specific prevention strategies. “Nowadays, more and more people are paying attention to the link between cancer and cardiovascular health,” said study co-authors Zeye Liu, M.D., Ph.D., and Yi Shi, M.D., Ph.D., both from Peking University People’s Hospital. “Breast cancer and atrial fibrillation/flutter rise together across many regions of the world and share the same modifiable risk factors.”
The American Heart Association’s Life’s Essential 8 highlights key behaviors and health factors essential for prevention. Laxmi Mehta, M.D., FAHA, chair of the Association’s Council on Clinical Cardiology, who was not involved in the study, noted: “This overlap underscores the importance of integrated lifestyle strategies to reduce risk of cardiovascular disease and cancer.”
Study limitations include that it reviewed a large global database with broad healthcare information by country, lacking individual-level data, and the findings cannot prove direct cause and effect. The researchers plan to incorporate long-term research, genetic and metabolic data, and socioeconomic factors in future studies.
