Patients with heart failure may be more likely to develop cancer, a new study involving over 200,000 people has found.

German researchers set out the investigate the link between heart failure and new cases of cancer, using information from a nationally representative database that covered over 1,200 general practices in Germany.

Some 100,124 patients with heart failure and 100,124 people without heart failure were included in the analysis. None of the participants had cancer at the start of the study. Statistical models were used to examine the association between heart failure and the incidence of cancer over a 10-year period.

The average age of the participants was 72 years and just over half (54%) were women.

The study found that over the 10-year observation period, the incidence of cancer was significantly higher (26%) among those with heart failure compared to those without heart failure (16%).

In women, the incidence of cancer was found to be 29% in patients with heart failure and 19% in those without  the heart condition. In men, the corresponding rates were 23% and 14%.

The researchers found significant links between heart failure and all the types of cancer that were assessed. The biggest increase in risk was observed for cancers of the lip, oral cavity and pharynx.

The study’s lead author, Dr Mark Luedde of the Christian-Albrechts University of Kiel, acknowledged that this was an observational study “and the results do not prove that heart failure causes cancer”.

“However, 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 tumour growth,” he suggested.

He pointed out that it is common practise for cancer patients who have received heart-damaging drugs to be monitored for heart failure, but these findings suggest that heart failure patients “may benefit from cancer prevention measures”.

“Evidence is accumulating to indicate that heart failure patients could benefit from intensive monitoring for cancer development, for example through screening. Considering the high incidence of both diseases and their impact on the lives of those affected, these patients deserve the maximum joint efforts of cardiologists and oncologists,” he said.

Details of these findings were recently presented at Heart Failure 2021, an online scientific congress of the European Society of Cardiology (ESC). They are also published in the journal, ESC Heart Failure.