A new global analysis published today in the Journal of the American Heart Association reveals that alcohol use and smoking are linked to higher rates of both breast cancer and atrial fibrillation/flutter in women aged 55 and older across multiple regions worldwide. 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 concentrated in Western nations such as the United States, Canada, Australia, New Zealand, and much of Europe.
The research, led by investigators at Peking University People's Hospital in Beijing, utilized machine learning to examine 58 shared and distinct risk factors for the two conditions. After accounting for multiple variables, smoking and alcohol use emerged as key contributors. The analysis estimated 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.
“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.
The study, which focused on women 55 and older, evaluated data from the Global Burden of Disease 2021 database. Researchers found that among 202 countries analyzed, 80 (39%) had similar rates of both conditions, 65 (32%) were breast cancer-dominant, and 57 (28%) were atrial fibrillation/flutter-dominant. High-income and developed nations exhibited elevated rates of both diseases, aligning with previous research linking Western diets and sedentary lifestyles to increased risks of cardiovascular and metabolic conditions and cancer.
“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 spatial risk maps 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 and region-specific prevention approaches.
Laxmi Mehta, M.D., FAHA, chair of the American Heart Association’s Council on Clinical Cardiology, who was not involved in the study, commented: “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 American Heart Association has previously highlighted the shared risk factors between breast cancer and cardiovascular disease in a 2018 Scientific Statement. The Association’s Life’s Essential 8 emphasizes key behaviors and health factors essential for prevention.
Study limitations include the use of a large global database with country-level data that lacks individual-level information, meaning the findings cannot prove direct cause and effect. Additionally, data collection may vary by country resources and screening practices.
