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. The study, which evaluated data from 204 countries and territories, found that in approximately 40% of these regions, the incidence rates of the two conditions were similar, with the highest-risk zones concentrated in Western nations.
Researchers identified modifiable risk factors, particularly alcohol use and smoking, that could substantially reduce the impact of both conditions. According to the analysis, reducing alcohol intake and smoking could potentially lower the risk of breast cancer by about 15% and atrial fibrillation/flutter by about 12% worldwide. 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 in Beijing.
The study, which is the first to use machine learning to investigate global patterns and shared risk factors, created spatial risk maps that can guide region-specific prevention strategies. High-income and developed nations, including the U.S., 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.
“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.
The analysis examined exposure to 58 risk factors, encompassing environmental, lifestyle, and metabolic factors. After accounting for multiple variables, smoking and alcohol use were the primary contributors. The study’s results revealed that high-risk zones were mostly in Western countries with greater exposure to smoking and alcohol use compared to Eastern regions, attributable to differences in lifestyle and social factors.
“Nowadays, more and more people are paying attention to the link between cancer and cardiovascular health,” said study co-authors Zeye Liu, M.D., Ph.D., a surgeon in the department of cardiac surgery of Peking University People’s Hospital, and Yi Shi, M.D., Ph.D., the director of the department of cardiac surgery at Peking University People’s Hospital in Beijing. “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, noted that “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’s Life’s Essential 8 highlights key behaviors and health factors essential for prevention and reducing risk.”
The study, published in the Journal of the American Heart Association, an open access, peer-reviewed journal, used data from the Global Burden of Disease 2021 database. Limitations include the use of country-level data, which cannot prove cause and effect, and potential variations in data collection across countries.
Additional resources and the full manuscript are available online. The American Heart Association’s Life’s Essential 8 provides guidance on key health behaviors.
