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 across multiple regions of the world. The study, which analyzed data from 204 countries and territories, suggests that these modifiable risk factors could be targeted to reduce the burden of both conditions simultaneously.
Researchers evaluated the rates of breast cancer and atrial fibrillation/flutter in women 55 and older using the Global Burden of Disease 2021 database. They examined exposure to 58 risk factors, including smoking, alcohol use, body mass index, and physical activity. The analysis found that in about 40% of the countries evaluated, the rates of both conditions were similar, with the highest-risk zones 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 revealed 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. Alcohol use alone 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.”
Study co-authors Zeye Liu, M.D., Ph.D., and Yi Shi, M.D., Ph.D., both from Peking University People’s Hospital, noted that the findings underscore the link between cancer and cardiovascular health. “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.”
Laxmi Mehta, M.D., FAHA, chair of the American Heart Association’s Council on Clinical Cardiology, who was not involved in the study, emphasized the importance of integrated lifestyle strategies. “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 newly developed spatial risk maps from the study can help guide region-specific prevention strategies. Researchers noted that high-risk zones in Western countries were associated with greater exposure to smoking and alcohol use compared to Eastern regions, as well as higher body mass index and more sedentary lifestyles due to industrialization and Western diets.
The American Heart Association has previously identified that breast cancer and cardiovascular disease share common risk factors, as outlined in a 2018 Scientific Statement. The Association’s Life’s Essential 8 highlights key behaviors and health factors essential for prevention.
Study limitations include the use of broad healthcare information by country without individual-level data, and the findings cannot prove direct cause and effect. The researchers plan to incorporate long-term research, genetic and metabolic data, and socioeconomic factors in future studies to develop individualized and region-specific prevention strategies.
