Life's Simple 7 for cardiovascular health is associated with cancer risk in the Moli-sani Study

BACKGROUND: Cardiovascular disease and cancer share modifiable risk factors and, potentially, molecular mechanisms of disease, as postulated by the “common soil” hypothesis. We examined whether the American Heart Association's Life's Simple 7 (LS7) metrics to assess and promote cardiovascular health, is associated with cancer risk, defined as first hospital admission for any cancer obtained through record linkage with hospital discharge forms. METHODS: Longitudinal analyses on 21,705 apparently cancer-free participants (mean age 55.2±11.6; 51.9% women) at cohort entry in the Moli-sani Study (2005-2010). Components of the LS7 include cigarette smoking, physical activity, diet, body mass index, blood pressure, cholesterol and glucose: each ideal CV health metric was assigned 2 points, and all points were summed to compute a CV health score ranging between 0 to 14 points. CV health scores were then classified as poor (0 to 6), average (7 to 9), and ideal (10 to 14). RESULTS: Over a median follow up of 13 y, a total of 1,918 hospital admissions for any cancer were recorded. The proportion of poor, intermediate and ideal CV health were respectively 33.2%, 47.6%, and 19.2%. In a multivariable-adjusted COX analysis controlled for known risk factors, participants in the ideal CV health category experienced 29% lower risk of cancer hospitalization (HR = 0.71; 95%CI 0.61-0.83) compared with the poor CV health category. These associations tended to be stronger in men (HR = 0.60; 95%CI 0.48-0.76) than in women (HR = 0.80; 95%CI 0.64-0.99), but were of the same magnitude in both the elderly (aged ≥65 y; HR = 0.74; 0.55-0.99) and younger participants (aged <65 y; HR = 0.75; 95%CI 0.63-0.90). CONCLUSIONS: Results from this large cohort of middle-aged and elderly Italians suggest that improving cardiovascular health could also reduce the future burden of cancer, supporting the hypothesis of a common soil of underlying risk factors for these two groups of diseases. KEY MESSAGES: • The Life’s Simple 7 metric initially developed to promote cardiovascular health is associated with future cancer risk in a large population of middle-aged and elderly Italians. • These findings reinforce the notion of a “common soil” of underlying risk factors for cardiovascular disease and cancer, and support common public health strategies for prevention.