Pulmonary Hypertension Tied to Increased Cancer Risk
People with pulmonary hypertension are at increased risk of developing cancer, especially lung and skin cancers, a new study indicates.
The study, “Pulmonary hypertension is associated with an increased incidence of cancer diagnoses,” was published in the journal Pulmonary Circulation.
Pulmonary hypertension (PH) refers to high blood pressure in the lung’s blood vessels, which puts strain on the lungs and the heart. People with PH are known to be at increased risk of certain other health conditions (comorbidities), including some respiratory and cardiovascular diseases as well as diabetes and depression. Whether PH is associated with cancer has not been clear.
Here, a team of scientists in Germany used a medical database to identify clinical and demographic data for 11,109 people with PH, and an equal number without. In both groups, the mean age was about 70 years, and slightly more than half of the patients were female.
Notably, there were no differences between the two groups in terms of comorbidities. There also was no difference in the prevalence of risk factors for PH and cancer such as obesity, diabetes, heart failure, atrial fibrillation (an irregular and often very rapid heart rate) and lipid (fat) metabolism.
Within 10 years of being diagnosed with PH, 23.2% of patients were diagnosed with cancer. By comparison, over a matched 10 years, 18.5% of those without PH were diagnosed with cancer.
Statistical analyses demonstrated that PH patients were significantly more likely to get cancer, by approximately 30%. Similar results were seen in analyses of males and females. As for age groups, cancer risk was significantly higher in PH patients older than 70, but in younger patients.
Additional analyses showed that this association was particularly strong for some cancer types: specifically, PH patients were about 60% more likely to be diagnosed with a cancer of the lungs or other part of the respiratory system, and they were 48% more likely to get skin cancer.
“We identified PH as an independent risk factor for cancer development within 10 years after initial diagnosis of pulmonary hypertension. This significant difference was driven by two cancer types: respiratory cancers and skin cancers,” the researchers concluded.
The team emphasized that, although this result shows a statistical association between the two diseases, it does not directly suggest that PH causes cancer.
“Nevertheless, we believe that the possible causal links between the two entities deserve closer consideration,” the scientists wrote, noting that biological signaling pathways have been implicated in PH and also cancer. They further suggested that the link between these disorders may be due to pulmonary damage by cancer therapies.
The team also noted a need for more studies to see whether the association goes the other way — that is, if cancer patients may be at higher risk of PH.
“Cancer is a particularly significant comorbidity in PH patients. The care of cancer and PH patients must take this comorbidity into account to a greater extent, especially if we wish to further extend the lifespans of these patient groups,” the researchers wrote.