Adults with advanced stages of cardiovascular-kidney-metabolic (CKM) syndrome may have a substantially elevated risk of developing cancer, according to a study published today in the American Heart Association's journal Circulation: Population Health and Outcomes. The research, which analyzed nearly 1.4 million adults, found that those in stage 3 or 4 of CKM syndrome had a 25% to 30% higher risk of cancer compared to individuals with no CKM risk factors.
CKM syndrome encompasses the interconnected conditions of heart disease, stroke, kidney disease, obesity, and diabetes. According to the American Heart Association, nearly 9 out of 10 U.S. adults have at least one component of CKM syndrome, such as high blood pressure, abnormal cholesterol, high blood glucose, excess weight, or reduced kidney function. The syndrome is staged from 0 (no risk factors) to 4 (established cardiovascular disease like heart attack or stroke).
Researchers at the University of Tokyo in Japan reviewed national insurance claims data to determine participants' CKM syndrome stage and tracked them for about 3.5 years, recording new cancer diagnoses. The results showed that cancer risk increased only modestly in early stages—3% higher for stage 1 and 2% for stage 2—but jumped sharply in later stages: 25% higher for stage 3 and 30% higher for stage 4.
“The study findings suggest that it is important to consider not only cardiovascular disease risk, but also cancer risk in people with CKM syndrome,” said Dr. Hidehiro Kaneko, the study's lead author and associate professor at the University of Tokyo. He noted that dysfunction in each of these systems is independently associated with cancer risk due to shared risk factors, and that “the accumulation of risk factors within the framework of CKM syndrome may contribute to the development of various types of cancer.”
The concept of reverse cardio-oncology—where cardiovascular disease and its risk factors also increase cancer risk—is underscored by these findings. “We already know that cancer and its therapies can lead to cardiotoxicities and cardiovascular disease,” said Dr. Tochukwu Okwuosa, director of cardio-oncology at Rush University Medical Center and an American Heart Association volunteer. “The study highlights the bidirectional relationship and underscores the concept of reverse cardio-oncology where cardiovascular disease and its risk factors also increase cancer risk.” She added that the CKM syndrome staging framework may be a useful tool to identify high-risk individuals for potential cancer screenings and evaluations.
While the study was conducted in a Japanese population, the authors note that other studies have “consistently reported that metabolic and kidney dysfunction are associated with increased risk of cancer,” supporting the generalizability of the findings. The American Heart Association's CKM Health Initiative provides additional resources on managing these interconnected conditions.
Healthy lifestyle choices may impact both conditions, which are leading causes of death in the United States. For individuals with established cardiovascular risk, discussing cancer screening options with a healthcare provider may be warranted.
