RT Journal Article
SR Electronic
T1 Is the number of ideal cardiovascular health metrics in midlife associated with lower risk of cancer? Evidence from 3 European prospective cohorts
JF CMAJ Open
JO CMAJ
FD Canadian Medical Association
SP E774
OP E781
DO 10.9778/cmajo.20220175
VO 11
IS 4
A1 van Sloten, Thomas T.
A1 Climie, Rachel E.D.
A1 Deraz, Omar
A1 Périer, Marie-Cécile
A1 Valentin, Eugenie
A1 Fayosse, Aurore
A1 Sabia, Séverine
A1 Weiderpass, Elisabete
A1 Jouven, Xavier
A1 Goldberg, Marcel
A1 Zins, Marie
A1 Touvier, Mathilde
A1 Deschasaux-Tanguy, Mélanie
A1 Fezeu, Léopold
A1 Hercberg, Serge
A1 Singh-Manoux, Archana
A1 Empana, Jean-Philippe
YR 2023
UL http://www.cmajopen.ca/content/11/4/E774.abstract
AB Background: Primordial prevention may be a relevant strategy for the prevention of cancer. Given the commonality of risk factors and mechanisms between cancer and cardiovascular disease, we examined the associations between the number of ideal cardiovascular health metrics in midlife and incident cancer.Methods: In 3 European cohorts (NutriNet-Santé and GAZEL, France; Whitehall II, United Kingdom), the number of ideal cardiovascular health metrics was determined at baseline (range 0–7). Follow-up for cancer events was until October 2020 (NutriNet-Santé), March 2017 (Whitehall II) and December 2015 (GAZEL). Cox regression was conducted in each cohort, and results were thereafter pooled using a random-effects model.Results: Data were available on 39 718 participants. A total of 16 237 were from NutriNet-Santé (mean age 51.3 yr; 28% men), 9418 were from Whitehall II (mean age 44.8 yr; 68% men) and 14 063 were from GAZEL (mean age 45.2 yr; 75% men). The median follow-up was 8.1 years in NutriNet-Santé, 29.6 years in Whitehall II and 24.8 years in GAZEL, and yielded a total of 4889 cancer events. A greater number of ideal cardiovascular health metrics was associated with a lower overall cancer risk in each cohort, with an aggregate hazard ratio (HR) per 1 increment in number of ideal metrics of 0.91 (95% confidence interval [CI] 0.88–0.93). This association remained after removal of the smoking metric (aggregate HR per unit increment in number of ideal metrics: 0.94, 95% CI 0.90–0.97), and site-specific analysis demonstrated a significant association with lung cancer.Interpretation: A greater number of ideal cardiovascular health metrics in midlife was associated with lower cancer risk, notably lung cancer. Primordial prevention of cardiovascular risk factors in midlife may be a complementary strategy to prevent the onset of cancer.