Living with heart failure is hard enough, but a new study suggests that these patients may also face a higher risk of cancer.

Researchers looked at more than 100,000 heart failure patients and the same number of people without heart failure. Their average age was just over 72 and none had cancer at the start of the study.

Over 10 years of follow-up, cancer rates were 25.7% among heart failure patients and 16.2% among those without heart failure. By gender, rates were 28.6% in women with heart failure, 18.8% in women without heart failure, 23.2% in men with heart failure and 13.8% in men without heart failure.

The study was presented June 28 at an online meeting of the European Society of Cardiology and simultaneously published in the journal ESC Heart Failure.

“This was an observational study and the results do not prove that heart failure causes cancer,” said study author Mark Luedde, from Christian-Albrechts-University of Kiel and Cardiology Joint Practice Bremerhaven, in Germany. “However, the findings do suggest that heart failure patients may benefit from cancer prevention measures.”

Heart failure affects roughly 65 million people worldwide.

“Our results allow us to speculate that there may be a causal relationship between heart failure and an increased rate of cancer. This is biologically plausible, as there is experimental evidence that factors secreted by the failing heart may stimulate tumor growth,” Luedde said in an ESC news release.

“While heart failure and cancer share common risk factors such as obesity and diabetes, these were accounted for in the analysis by matching,” he explained. But the researchers did not have information on smoking, alcohol consumption or physical activity, so these factors were not used in the analysis.

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