Myocardial infarction and future risk of cancer in the general population—the Tromsø Study

• Published in: European Journal of Epidemiology
• Main Authors: Rinde, Ludvig Balteskard, Småbrekke, Birgit, Mathisen Hald, Erin, Brodin, Ellen Elisabeth, Njølstad, Inger, Mathiesen, Ellisiv B., Løchen, Maja-Lisa, Wilsgaard, Tom, Brækkan, Sigrid Kufaas, Vik, Anders, Hansen, John-Bjarne
• Format: Article in Journal/Newspaper
• Language: English
• Published: Springer Verlag (Germany) 2017
• Subjects: VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771; VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Cardiology: 771; Myocardial infarction; Cancer; Epidemiology; Risk factors; Tromsø
• Online Access: https://hdl.handle.net/10037/13483; https://doi.org/10.1007/s10654-017-0231-5

This is a post-peer-review, pre-copyedit version of an article published in European Journal of Epidemiology. The final authenticated version is available online at: https://doi.org/10.1007/s10654-017-0231-5 . 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.