A global analysis published on Jul. 10 reveals that breast cancer and atrial fibrillation most closely overlap in women aged 55 and older, with smoking and alcohol use identified as shared modifiable risk factors that could inform targeted prevention strategies.
The study, featured in the Journal of the American Heart Association, mapped geospatial patterns and hotspots for both breast cancer (BC) and atrial fibrillation/flutter (AF) among older women across 204 countries and territories. Researchers used Global Burden of Disease 2021 data to examine incidence rates, shared epidemiological features, and possible etiological links between the two conditions.
Breast cancer remains a leading malignancy among women worldwide. Incidence is higher in developed regions, while mortality is often greater in lower-incidence areas such as parts of Asia and Africa. Major risk factors for BC include genetic predisposition, hormonal history, obesity, alcohol use, and physical inactivity, with an estimated quarter of cases preventable by addressing lifestyle factors. Atrial fibrillation is the most common cardiac arrhythmia globally; its prevalence increases with age and frequently co-occurs with BC due to overlapping risk factors like aging, obesity, metabolic syndrome, and alcohol use.
Researchers classified countries based on incidence quartiles into consistent (both diseases within same quartile), AF-dominant or BC-dominant groups. Machine learning techniques were applied to identify key candidate risk factors from an initial set of 58 variables. The main risks identified for both diseases included smoking and alcohol use; high body mass index (BMI) was specific to BC while high sodium intake was linked to AF. Alcohol emerged as the strongest risk factor: a one-standard-deviation increase was associated with up to a 12% higher BC incidence rate and a 10% higher AF incidence rate among older women.
Western nations such as the United States, Canada, Australia—and regions including Europe—showed highest exposure levels for smoking and alcohol consumption. High BMI was prevalent in Pacific Islands and Middle Eastern countries like Kuwait or Qatar; low physical activity rates were noted especially in places such as Marshall Islands or American Samoa. Countries exhibited unique profiles but shared significant overlap between disease-specific risks.
The authors concluded that integrated approaches are needed to address these overlapping public health challenges: “Combining insights from spatial epidemiology, machine learning, and clinical research enables a deeper understanding of how these diseases may share common population-level drivers,” they said. They also said continued research using diverse data sources will be essential for refining prevention strategies.
