Myocardial infarction and future risk of cancer in the general population - The Tromso Study

The association between myocardial infarction (MI) and future risk of incident cancer is scarcely investigated. Therefore, we aimed to study the risk of cancer after a first time MI in a large cohort recruited from a general population. Participants in a large population-based study without a previo...

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Bibliographic Details
Published in:European Journal of Epidemiology
Main Authors: Rinde, Ludvig B., Smabrekke, Birgit, Hald, Erin M., Brodin, Ellen E., Njølstad, Inger, Mathiesen, Ellisiv Bøgeberg, Loechen, Maja-Lisa, Wilsgaard, Tom, Braekkan, Sigrid K., Vik, Anders, Hansen, John-Bjarne
Format: Article in Journal/Newspaper
Language:unknown
Published: Springer Netherlands 2017
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Online Access:https://doi.org/10.1007/s10654-017-0231-5
Description
Summary:The association between myocardial infarction (MI) and future risk of incident cancer is scarcely investigated. Therefore, we aimed to study the risk of cancer after a first time MI in a large cohort recruited from a general population. Participants in a large population-based study without a previous history of MI or cancer (n = 28,763) were included and followed from baseline to date of cancer, death, migration or study end. Crude incidence rates (IRs) and hazard ratios (HRs) for cancer after MI were calculated. During a median follow-up of 15.7 years, 1747 subjects developed incident MI, and of these, 146 suffered from a subsequent cancer. In the multivariable-adjusted model (adjusted for age, sex, BMI, systolic blood pressure, diabetes mellitus, HDL cholesterol, smoking, physical activity and education level), MI patients had 46% (HR 1.46; 95% CI: 1.21–1.77) higher hazard ratio of cancer compared to those without MI. The increased cancer incidence was highest during the first 6 months after the MI, with a 2.2-fold higher HR (2.15; 95% CI: 1.29–3.58) compared with subjects without MI. After a 2-year period without higher incidence rate, MI patients displayed 60% (HR 1.60; 95% CI: 1.27–2.03) higher HR of future cancer more than 3 years after the event. The increased IRs were higher in women than men. Patients with MI had a higher short- and long-term incidence rate of cancer compared to subjects without MI. Our findings suggest that occult cancer and shared risk factors of MI and cancer may partly explain the association.