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. The study, which analyzed data from 204 countries and territories, found that in about 40% of these regions, the rates of both conditions were similar, with the highest-risk zones in Western nations.
Breast cancer and atrial fibrillation (AFib), an irregular heartbeat, represent a growing global health burden. Researchers sought to understand why these conditions have similar rates in specific parts of the world. “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 analysis evaluated women’s exposure to 58 shared and distinct health, behavioral and lifestyle risk factors, including smoking, alcohol use, body mass index and physical activity. Researchers noted that 80 countries or territories (39%) had similar rates of both breast cancer and atrial fibrillation/flutter. About 65 countries (32%) were breast cancer-dominant, and 57 countries (28%) were atrial fibrillation/flutter-dominant.
After accounting for multiple variables, smoking and alcohol use were linked to higher rates of both conditions. An additional analysis found 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. Alcohol use was found to be a significant contributor to breast cancer (9.27% of cases) and atrial fibrillation/flutter (7.57% of cases).
High-income and developed nations, such as the U.S., Canada, Australia, New Zealand and much of Europe, exhibited elevated rates of both breast cancer and AFib, 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. “This is the first study combining global data with machine learning to show the relationship between the conditions, their location across the world and the shared risk factors of these two conditions.”
The study results revealed high-risk zones were mostly in Western countries where there was greater exposure to smoking and alcohol use compared to Eastern regions. Additionally, Western nations were more likely to have exposure to more types of risk factors, such as higher body mass index and more sedentary lifestyles.
“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., from the department of cardiac surgery at 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. From a cardiovascular perspective, this means that reducing smoking and alcohol use could help lower the risk of both conditions at the same time.”
Laxmi Mehta, M.D., FAHA, chair of the American Heart Association’s Council on Clinical Cardiology, who was not involved in the study, noted, “Many of the same modifiable factors, including smoking, alcohol use, poor diet, physical inactivity and obesity, contribute to both breast cancer and cardiovascular disease including atrial fibrillation/flutter, as confirmed by this study’s findings. This overlap underscores the importance of integrated lifestyle strategies to reduce risk of cardiovascular disease and cancer.”
The newly developed spatial risk maps as part of this study can help guide region-specific prevention strategies. According to the researchers, the next step will be to incorporate long-term research, genetic and metabolic data, as well as socioeconomic factors, to develop individualized prevention strategies.
