A new global analysis published today in the Journal of the American Heart Association reveals that alcohol use and smoking are linked to both breast cancer and atrial fibrillation/flutter in women ages 55 and older, with similar rates of the two conditions occurring in about 40% of 204 countries and regions evaluated. The study, which used machine learning to examine patterns across the globe, found that high-income Western nations such as the United States, Canada, Australia, New Zealand, and much of Europe exhibited elevated rates of both conditions, highlighting the influence of lifestyle factors.
Researchers analyzed data from the Global Burden of Disease 2021 database, evaluating 58 shared and distinct risk factors including smoking, alcohol use, body mass index, and physical activity. After accounting for multiple variables, smoking and alcohol use were significantly associated with higher rates of both breast cancer and atrial fibrillation/flutter. An additional analysis suggested that reducing alcohol intake and smoking could potentially lower the risk of breast cancer by about 15% and atrial fibrillation/flutter by about 12% worldwide. Alcohol use alone contributed to 9.27% of breast cancer cases and 7.57% of atrial fibrillation/flutter cases.
“Identifying shared risk factors is important for developing interventions that support optimal health, such as smoking cessation and alcohol restriction, which could potentially reduce the global incidence of breast cancer and atrial fibrillation/flutter substantially,” said study co-author Shu Wang, M.D., Ph.D., director of the Breast Disease Center at Peking University People’s Hospital in Beijing.
The study identified 80 countries (39%) where rates of breast cancer and atrial fibrillation/flutter were similar, while 65 countries (32%) were breast cancer-dominant and 57 countries (28%) were atrial fibrillation/flutter-dominant. High-risk zones were mostly in Western countries with greater exposure to smoking and alcohol use compared to Eastern regions, as well as higher body mass index and more sedentary lifestyles due to industrialization and Western diets.
“One of the most surprising aspects of our findings was how common both breast cancer and atrial fibrillation/flutter diagnoses were among women ages 55 and older in high-income regions, which highlights the influence of lifestyle,” Wang said. “This is the first study combining global data with machine learning to show the relationship between the conditions, their location across the world and the shared risk factors of these two conditions.”
The study authors noted that the number of breast cancer and atrial fibrillation cases represents a growing global health burden. Co-authors Zeye Liu, M.D., Ph.D., and Yi Shi, M.D., Ph.D., both from Peking University People’s Hospital, emphasized that “breast cancer and atrial fibrillation/flutter rise together across many regions of the world and share the same modifiable risk factors. From a cardiovascular perspective, this means that reducing smoking and alcohol use could help lower the risk of both conditions at the same time.”
The American Heart Association’s Life’s Essential 8 highlights key behaviors and health factors essential for prevention, including diet, physical activity, and avoidance of tobacco and excessive alcohol. Laxmi Mehta, M.D., FAHA, chair of the Association’s Council on Clinical Cardiology, who was not involved in the study, noted, “Many of the same modifiable factors contribute to both breast cancer and cardiovascular disease including atrial fibrillation/flutter, as confirmed by this study’s findings. This overlap underscores the importance of integrated lifestyle strategies to reduce risk.”
The newly developed spatial risk maps from this study can help guide region-specific prevention strategies. Researchers plan to incorporate long-term research, genetic and metabolic data, and socioeconomic factors to develop individualized prevention approaches. The study, published in the Journal of the American Heart Association, is available online.
