A new, independent study published today in the Journal of the American Heart Association has identified that alcohol use and smoking are linked to both breast cancer and atrial fibrillation/flutter in women aged 55 years and older across multiple regions worldwide. The research, which analyzed data from 204 countries and territories, found that in about 40% of the regions evaluated, the rates of both conditions were similar, with the highest-risk zones concentrated in Western nations.
The study, led by researchers at Peking University People’s Hospital in Beijing, utilized the Global Burden of Disease 2021 database to investigate the incidence of breast cancer and atrial fibrillation, also known as AFib or irregular heartbeat. The analysis focused on women aged 55 and older and examined exposure to 58 shared and distinct risk factors, including smoking, alcohol use, body mass index, and physical activity. The findings underscore a growing global health burden, as both conditions are on the rise.
According to the study, approximately 80 countries (39%) had similar rates of both breast cancer and atrial fibrillation/flutter, while 65 countries (32%) were breast cancer-dominant and 57 countries (28%) were atrial fibrillation/flutter-dominant. After accounting for multiple variables, smoking and alcohol use emerged as significant contributors to both conditions. The researchers estimated that reducing alcohol intake and smoking could potentially lower 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.
High-income and developed nations, such as the United States, Canada, Australia, New Zealand, and much of Europe, exhibited elevated rates of both conditions, 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,” said study co-author Shu Wang, M.D., Ph.D., director of the Breast Disease Center at Peking University People’s Hospital.
The study is the first to combine global data with machine learning to show the relationship between the conditions, their geographic distribution, and shared risk factors. The newly developed spatial risk maps can help guide region-specific prevention strategies. “From a cardiovascular perspective, this means that reducing smoking and alcohol use could help lower the risk of both conditions at the same time,” said co-authors Zeye Liu, M.D., Ph.D., and Yi Shi, M.D., Ph.D., from the department of cardiac surgery at Peking University People’s Hospital.
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 contribute to both breast cancer and cardiovascular disease including atrial fibrillation/flutter, as confirmed by this study’s findings,” she said. The American Heart Association’s Life’s Essential 8 highlights key behaviors and health factors essential for prevention. The study’s limitations include its reliance on country-level data, which cannot prove direct cause and effect, and potential differences in screening and data collection across regions.
