“Cardiovascular Risk, Health Metrics, and Cancer Prediction: A Scoping Review”
Gretell Henriquez-Santos, MD, Ji-Eun Kim, PHD, Sant J. Kumar, MD Alicia A. Livinski, MPH, MA, et al.
JACC: CARDIO-ONCOLOGY, VOL.7, NO.5, 2025
Summary: At Cancer Fitness, Jay K. Harness, MD
This scoping review examined whether cardiovascular disease (CVD) risk scores and cardiovascular health (CVH) metrics, widely used to predict heart disease, can also forecast cancer risk. The review synthesized 13 prospective cohort studies, encompassing nearly one million adults, with follow-up ranging from 8 to almost 30 years
Four studies used CVD risk scores, such as ASCVD, SCORE, and Framingham Risk Score
while 10 evaluated CVH metrics, most often the American Heart Association’s Life’s Simple 7 (LS7) or Life’s Essential 8 (LE8).
Key Results:
- CVD risk scores: Higher scores consistently predicted increased cancer incidence. For example, high vs low ASCVD scores conferred up to a 3.7-fold greater cancer risk; SCORE predicted nearly a threefold increase.
- CVH metrics: Ideal CVH profiles (e.g., higher LS7 or LE8 scores) were linked with significantly lower cancer risk. Depending on the study and scoring system, better CVH reduced risk by 5–51%.
- Cancer types: Associations were strongest and most consistent for lung and colorectal cancer. For lung cancer, ideal LS7/LE8 scores reduced risk by up to 96%, while high ASCVD or SCORE scores elevated risk up to 12-fold. For colorectal cancer, higher CVH scores reduced risk by as much as 80%, while high CVD risk scores increased it up to 4-fold. Gastrointestinal cancers also showed strong links, with ASCVD scores predicting a sixfold higher risk. Evidence was mixed for breast and prostate cancer; only LE8 showed consistent protective association with breast cancer, while prostate cancer findings were inconsistent.
Mechanisms: Shared risk factors—including smoking, obesity, physical inactivity, poor diet, high blood pressure, and metabolic dysfunction—likely drive both CVD and cancer. Biological pathways include inflammation, oxidative stress, insulin resistance, and adiposity-related hormonal changes.
Limitations: Heterogeneity across studies, including differences in metrics, scales (continuous vs categorical), and cancer outcomes, precluded meta-analysis. Potential reverse causation, where undiagnosed cancers influence baseline risk factors, remains a concern.
Conclusions: Overall, worse CVD risk scores and poorer CVH metrics predict greater cancer risk. The review underscores the need for standardized scoring systems and cancer-specific research to refine predictive accuracy.
Implications for Patients
For patients, this evidence reinforces the importance of lifestyle and cardiovascular health not just for heart disease prevention but also for lowering cancer risk. Actions such as quitting smoking, maintaining healthy weight, being physically active, eating a balanced diet, controlling blood pressure and cholesterol, and ensuring adequate sleep all contribute to improved CVH metrics. Patients should view cardiovascular prevention efforts as “dual-purpose”: by protecting the heart, they may also be reducing their future risk of cancers, especially lung and colorectal cancer. Engaging in regular checkups and monitoring health metrics could offer long-term protection against multiple diseases.
Clinical-Facing SummaryCVD risk scores (ASCVD, SCORE, FRS) and CVH metrics (LS7, LE8) show strong predictivevalue for cancer incidence, particularly lung and colorectal cancers. Incorporating these tools into oncology prevention could facilitate earlier identification of at-risk individuals and enable integrated interventions targeting shared modifiable risk factors.
