Decreased risk of cardiovascular disease mortality associated with occasional positive screens following cancer screenings
Abstract Positive results from cancer screenings, like a cancer diagnosis, can increase the risk of cardiovascular disease (CVD) mortality due to heightened psychological stress. However, positive screening results may also serve as a teachable moment to encourage the adoption of a healthier lifesty...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-024-78252-2 |
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| author | Yuting Ji Yu Zhang Hongyuan Duan Xiaomin Liu Yunmeng Zhang Zhuowei Feng Jingjing Li Zeyu Fan Ya Liu Yacong Zhang Lei Yang Zhangyan Lyu Fangfang Song Fengju Song Hua Li Yubei Huang |
| author_facet | Yuting Ji Yu Zhang Hongyuan Duan Xiaomin Liu Yunmeng Zhang Zhuowei Feng Jingjing Li Zeyu Fan Ya Liu Yacong Zhang Lei Yang Zhangyan Lyu Fangfang Song Fengju Song Hua Li Yubei Huang |
| author_sort | Yuting Ji |
| collection | DOAJ |
| description | Abstract Positive results from cancer screenings, like a cancer diagnosis, can increase the risk of cardiovascular disease (CVD) mortality due to heightened psychological stress. However, positive screening results may also serve as a teachable moment to encourage the adoption of a healthier lifestyle. Consequently, the overall association between positive screenings and CVD mortality risk remains unclear. Based on PLCO data, the risk of CVD mortality associated with the number and types of positive screens was evaluated using Cox regression models among 149,258 eligible participants enrolled between 1993 and 2001. Additional analyses explored these associations stratified by prior CVD history. Exploratory analyses were also conducted to investigate whether positive screens were linked to the potential adoption of a healthier lifestyle. After a median follow-up of 19 years, significantly decreased risk of CVD mortality was observed for individuals with occasional positive screening (≤ 2 positive screens) [adjusted hazard ratio (HR, 95%CIs): 0.931 (0.897–0.968), P < 0.001] compared to the control arm. This effect was particularly notable for flexible sigmoidoscopy [0.842 (0.802–0.884), P < 0.001] and transvaginal ultrasound [0.855 (0.776–0.942), P = 0.002]. However, when the number of positive screens increased to more than two, the reduced risk of CVD mortality became non-significant [0.977 (0.941–1.014), P = 0.220]. Subgroup analyses revealed a greater reduction in CVD mortality risk among participants without a history of CVD [0.917 (0.864–0.973)] compared to those with a history of CVD [0.944 (0.898–0.993)]. Sensitivity analyses excluding screening-detected cancers showed similar association in the overall population [0.933 (0.897–0.970)], as well as in both subgroups with [0.945 (0.898–0.995)] and without previous CVD [0.919 (0.865–0.976)]. Exploratory analyses indicated a significantly higher proportion of any body mass index (BMI) reduction among those with a baseline BMI ≥ 25 kg/m2 who had positive screens compared to the control arm, particularly for individuals with occasional positive screens (48.07% vs. 47.04%, P value = 0.037). Occasional positive cancer screening are associated with reduced risk of CVD mortality, regardless of prior CVD history, cancer diagnosis, and other competitive risks. |
| format | Article |
| id | doaj-art-0c731011e49f4b92936963b31ad69466 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-0c731011e49f4b92936963b31ad694662025-01-19T12:20:04ZengNature PortfolioScientific Reports2045-23222025-01-0115111210.1038/s41598-024-78252-2Decreased risk of cardiovascular disease mortality associated with occasional positive screens following cancer screeningsYuting Ji0Yu Zhang1Hongyuan Duan2Xiaomin Liu3Yunmeng Zhang4Zhuowei Feng5Jingjing Li6Zeyu Fan7Ya Liu8Yacong Zhang9Lei Yang10Zhangyan Lyu11Fangfang Song12Fengju Song13Hua Li14Yubei Huang15Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityDepartment of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityDepartment of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityDepartment of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityDepartment of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityDepartment of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityDepartment of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityDepartment of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityDepartment of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityDepartment of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & InstituteDepartment of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityDepartment of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityDepartment of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityDepartment of Endoscopy, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and HospitalDepartment of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityAbstract Positive results from cancer screenings, like a cancer diagnosis, can increase the risk of cardiovascular disease (CVD) mortality due to heightened psychological stress. However, positive screening results may also serve as a teachable moment to encourage the adoption of a healthier lifestyle. Consequently, the overall association between positive screenings and CVD mortality risk remains unclear. Based on PLCO data, the risk of CVD mortality associated with the number and types of positive screens was evaluated using Cox regression models among 149,258 eligible participants enrolled between 1993 and 2001. Additional analyses explored these associations stratified by prior CVD history. Exploratory analyses were also conducted to investigate whether positive screens were linked to the potential adoption of a healthier lifestyle. After a median follow-up of 19 years, significantly decreased risk of CVD mortality was observed for individuals with occasional positive screening (≤ 2 positive screens) [adjusted hazard ratio (HR, 95%CIs): 0.931 (0.897–0.968), P < 0.001] compared to the control arm. This effect was particularly notable for flexible sigmoidoscopy [0.842 (0.802–0.884), P < 0.001] and transvaginal ultrasound [0.855 (0.776–0.942), P = 0.002]. However, when the number of positive screens increased to more than two, the reduced risk of CVD mortality became non-significant [0.977 (0.941–1.014), P = 0.220]. Subgroup analyses revealed a greater reduction in CVD mortality risk among participants without a history of CVD [0.917 (0.864–0.973)] compared to those with a history of CVD [0.944 (0.898–0.993)]. Sensitivity analyses excluding screening-detected cancers showed similar association in the overall population [0.933 (0.897–0.970)], as well as in both subgroups with [0.945 (0.898–0.995)] and without previous CVD [0.919 (0.865–0.976)]. Exploratory analyses indicated a significantly higher proportion of any body mass index (BMI) reduction among those with a baseline BMI ≥ 25 kg/m2 who had positive screens compared to the control arm, particularly for individuals with occasional positive screens (48.07% vs. 47.04%, P value = 0.037). Occasional positive cancer screening are associated with reduced risk of CVD mortality, regardless of prior CVD history, cancer diagnosis, and other competitive risks.https://doi.org/10.1038/s41598-024-78252-2Cardiovascular diseaseDeathCancerPositive screenCox regression modelCohort |
| spellingShingle | Yuting Ji Yu Zhang Hongyuan Duan Xiaomin Liu Yunmeng Zhang Zhuowei Feng Jingjing Li Zeyu Fan Ya Liu Yacong Zhang Lei Yang Zhangyan Lyu Fangfang Song Fengju Song Hua Li Yubei Huang Decreased risk of cardiovascular disease mortality associated with occasional positive screens following cancer screenings Scientific Reports Cardiovascular disease Death Cancer Positive screen Cox regression model Cohort |
| title | Decreased risk of cardiovascular disease mortality associated with occasional positive screens following cancer screenings |
| title_full | Decreased risk of cardiovascular disease mortality associated with occasional positive screens following cancer screenings |
| title_fullStr | Decreased risk of cardiovascular disease mortality associated with occasional positive screens following cancer screenings |
| title_full_unstemmed | Decreased risk of cardiovascular disease mortality associated with occasional positive screens following cancer screenings |
| title_short | Decreased risk of cardiovascular disease mortality associated with occasional positive screens following cancer screenings |
| title_sort | decreased risk of cardiovascular disease mortality associated with occasional positive screens following cancer screenings |
| topic | Cardiovascular disease Death Cancer Positive screen Cox regression model Cohort |
| url | https://doi.org/10.1038/s41598-024-78252-2 |
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