A new global analysis published today in the Journal of the American Heart Association has found that alcohol use and smoking are linked to both breast cancer and atrial fibrillation/flutter in women aged 55 and older, with rates of these conditions showing similar patterns across many regions worldwide. The study, which analyzed data from 204 countries and territories, suggests that reducing these modifiable risk factors could substantially lower the global burden of both diseases.
Researchers evaluated the incidence of breast cancer and atrial fibrillation/flutter, also known as AFib or irregular heartbeat, in women ages 55 and older using data from the Global Burden of Disease 2021 database. They examined exposure to 58 shared and distinct risk factors, including smoking, alcohol use, body mass index, and physical activity. The analysis found that in approximately 40% of the countries evaluated, rates of both conditions were similar, with the highest-risk zones concentrated in Western nations such as the United States, Canada, Australia, New Zealand, and much of Europe.
“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 results revealed that smoking and alcohol use were significant contributors to 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. Specifically, alcohol use was found to contribute to 9.27% of breast cancer cases and 7.57% of atrial fibrillation/flutter cases.
“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's co-authors, Zeye Liu, M.D., Ph.D., and Yi Shi, M.D., Ph.D., both from Peking University People’s Hospital, emphasized the importance of these findings. “Nowadays, more and more people are paying attention to the link between cancer and cardiovascular health,” they said. “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.”
The American Heart Association’s Life’s Essential 8 highlights key behaviors and health factors essential for prevention and reducing risk, including diet, physical activity, and avoidance of tobacco and excessive alcohol. The newly developed spatial risk maps from this study can help guide region-specific prevention strategies and provide precise targets for future research, according to the researchers.
Study limitations include its reliance on a large global database with broad healthcare information by country, which lacks individual-level data and cannot prove direct cause and effect. Nevertheless, the findings underscore the importance of integrated lifestyle strategies to reduce the risk of both cardiovascular disease and cancer.
