Heart Failure and Cancer: Incidence and Mortality Patterns, A Systematic Review and Meta-analysis
In brief
Heart failure raises overall cancer risk by about one third
A meta-analysis of nearly nine million people found that having heart failure increased the chance of developing any cancer by roughly 33%, with especially higher rates of lung (70% increase), colorectal (28% increase) and breast (19% increase) cancers. The evidence varied widely across studies and mortality data were limited, underscoring the need for more uniform research.
- Journal
- European journal of heart failure (Q1)
- Published
- 25 August 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Luigi Sanasi, Antonio Iaconelli, Danila Azzolina, Pasquale Dolce, Christian Cardile, Lorenzo Cacioli, et al.
- PMID
- 42640052
- DOI
- 10.1093/ejhf/xuag265
Why clinicians should know about it
- Picked for Epidemiology (paper of the day, 27 August 2026): Meta‑analysis of heart failure and cancer incidence/mortality
Abstract
BACKGROUND: Cancer and heart failure (HF) frequently coexist due to population ageing and improved survival for both conditions. HF is a well-recognised complication of oncologic therapies and a potential association between HF and subsequent cancer incidence has been recently noticed. We therefore conducted a meta-analysis to quantify cancer incidence and mortality in patients with and without HF. METHODS: Databases were searched from inception to 15 February 2026. Data from observational studies and randomised trials on individuals with and without HF and reporting cancer incidence and/or mortality during follow-up were included. The main outcome of interest was the incidence of any cancer; secondary outcomes included site-specific cancer incidence (lung, colorectal, breast, and prostate) and all-cause, cardiovascular, and cancer-related mortality. RESULTS: Twelve studies comprising 8,979,195 individuals were included. HF was associated with a higher incidence of cancer (hazard ratio [HR] 1.33, 95% confidence interval [CI] 1.14-1.54), with substantial heterogeneity (I2 = 99.7%). Cancer site-specific analyses showed increased incidences of lung (HR 1.70, 95% CI 1.26-2.29), colorectal (HR 1.28, 95% CI 1.11-1.48), and breast (HR 1.19, 95% CI 1.04-1.37), but not prostate, cancer. Effect estimates varied according to analytical strategy: matched HF and non-HF cohorts reported higher risk estimates than those using covariate adjustment without matching. Mortality data were sparse and heterogeneous. CONCLUSIONS: HF is associated with a higher incidence of cancer, although with marked heterogeneity among studies and cancer types. Mortality and cause of death were rarely reported. The observed HF-cancer association is influenced by statistical methodology, shared risk factors, differences in surveillance intensity and cancer type, that confound analyses investigating possible causal biological links. More granular and harmonised studies are required.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.