Prevalence, Incidence, and Impact of Cancer in Atrial Fibrillation: A Systematic Review and Meta-Analysis of 70,000,000 Patients.

BACKGROUND AND AIMS: Contemporary studies indicate that atrial fibrillation (AF) is common in patients with cancer and adversely affects their prognosis. AF and cancer also share several risk factors. Nevertheless, the prevalence, incidence, and overall impact of cancer in patients with AF are not well defined. This study was designed to estimate the prevalence and incidence of cancer in an AF population and to evaluate its effect on clinical outcomes.

METHODS

A systematic review and meta-analysis were performed following international guidelines. We searched PubMed, Web of Science, Embase, and Cochrane Library for studies reporting the prevalence and incidence of cancer in patients with AF. Data were extracted from the included studies and pooled using a random-effects model.

RESULTS

The overall prevalence of cancer among AF patients was 1141.01 per 10,000 (95% CI: 975.43-1330.56; 95% PI: 219.37-4251.57), with an incidence of 172.22 per 10,000 person-years (95% CI: 127.76-232.15; 95% PI: 40.32-735.69). Both prevalence and incidence varied according to cancer type, patient gender, and comorbid conditions. Cancer was associated with a significantly increased risk of all-cause mortality (OR: 1.83, 95% CI: 1.60-2.08) and bleeding (OR: 1.62, 95% CI: 1.37-1.92). No significant associations were observed for cardiovascular death or stroke/systemic embolism.

CONCLUSIONS

Cancer is common in AF patients, affecting approximately 11% of this population. In addition, the incidence of cancer in AF patients is substantial and should not be overlooked. Cancer is associated with worse clinical outcomes in AF patients, including a more than 1.8-fold increased risk of all-cause mortality and 1.6-fold increased risk of bleeding.