Cancer and atrial fibrillation comorbid state among 25 million citizens in Shanghai, China (Preprint)

BACKGROUND The epidemiological data on the comorbid state of cancer and atrial fibrillation (AF) are generally scanty, especially in China. OBJECTIVE To evaluate the profile of comorbid cancer in AF population in Shanghai, China. METHODS Data was screened from the Shanghai Municipal Health Commission database between 2015 and 2020, which covered all medical records of 25,964,447 adults with medical insurance. The cancer profile was evaluated in AF population relative to the age- and sex-adjusted non-AF subjects. Sex distribution and the peak age of cancer were also accessed. RESULTS A total of 22,185 subjects with cancer were identified among 268,401 AF patients, yielding a higher cancer prevalence in AF than in non-AF populations (8.27% vs. 6.05%, p<0.0001). AF was associated with a 1.4-fold increased risk of cancer after adjusting for age and sex. The increased risk of cancer in AF was observed in 20 out of 21 cancer sites, which was most prominent in non-solid tumors (including multiple myeloma, leukemia, and non-Hodgkin lymphoma) and intrathoracic malignancies (including mediastinum, lung and esophageal cancers). In AF population, cancer risk was higher in men than in women in 14 out of 18 cancer sites, while female predominance was only found on thyroid cancer. The peak age of cancer was lower in AF (70-74 years) than in non-AF population (75-79 years). CONCLUSIONS Patients with AF are associated with increased risk, heightened male predominance and earlier peak age of cancer. Early screening of cancers might be beneficial in AF population to facilitate earlier diagnosis and treatment.