心血管和心脏代谢疾病中癌症的患病率：一项系统评价和荟萃分析。
完整摘要 · 中文译文
背景：据我们所知，既往尚无系统评价全面量化本研究所纳入的广泛心血管和心代谢疾病谱中的癌症患病率。我们旨在估计冠状动脉疾病（CAD）、心力衰竭（HF）、心房颤动（AF）、高血压、2型糖尿病（DM）、卒中、外周动脉疾病（PAD）和心脏瓣膜病（VHD）患者中活动性癌症（主要结局）及其他癌症类别的合并患病率。 方法：检索了PubMed、Web of Science和Scopus中2010年至2024年7月的文献。次要结局包括任何癌症、既往癌症、血液系统癌症、实体器官癌症和转移性癌症的患病率。采用单步广义线性混合模型计算患病率估计值。 结果：共纳入676项研究，涉及约1.8亿名受试者。活动性癌症的主要分析包括59项研究（4,759,695例患者）。活动性癌症患病率范围为2型DM的4.22%（95%置信区间[CI] 2.18-5.32）至AF的5.55%（95% CI 3.97-7.01）。任何癌症患病率（一项判定方法异质性更大的次要结局）范围为CAD的7.04%（95% CI 6.05-8.03）至AF的14.10%（95% CI 12.20-15.99）。 结论：癌症是心血管和心脏代谢疾病中的一种重要合并症。尽管各研究中癌症的确定方法有所不同，尤其是对于任何癌症而言，但本研究结果提供了癌症负担的最新估计，可为未来的心脏肿瘤学研究、医疗规划、风险分层以及心血管和心脏代谢临床试验的设计提供参考。 试验注册：PROSPERO CRD42023494764。
完整摘要 · 英文原文
BACKGROUND: To the best of our knowledge, no previous systematic review has comprehensively quantified cancer prevalence across the broad spectrum of cardiovascular and cardiometabolic conditions included in the present study. We aimed to estimate pooled prevalence of active cancer (primary outcome) and other cancer categories among patients with coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), hypertension, Type 2 diabetes mellitus (DM), stroke, peripheral artery disease (PAD), and valvular heart disease (VHD). METHODS: PubMed, Web of Science, and Scopus were searched from 2010 to July 2024. Secondary outcomes included prevalence of any, previous, haematological, solid, and metastatic cancer. Prevalence estimates were calculated using one-step generalized linear mixed models. RESULTS: A total of 676 studies comprising approximately 180 million participants were included. The primary analysis of active cancer included 59 studies (4,759,695 patients). Active cancer prevalence ranged from 4.22% (95% confidence interval [CI] 2.18-5.32) in Type 2 DM to 5.55% (95% CI 3.97-7.01) in AF. The prevalence of any cancer, a secondary outcome with more heterogeneous ascertainment, ranged from 7.04% (95% CI 6.05-8.03) in CAD to 14.10% (95% CI 12.20-15.99) in AF. CONCLUSION: Cancer represents a substantial comorbidity across cardiovascular and cardiometabolic conditions. Although cancer ascertainment methods varied across studies, particularly for any cancer, the findings provide contemporary estimates of cancer burden that may inform future cardio-oncology research, healthcare planning, risk stratification, and the design of cardiovascular and cardiometabolic clinical trials. TRIAL REGISTRATION: PROSPERO CRD42023494764.