It is difficult to overstate the importance of cancer and cardiovascular disease (CVD), or the risk factors that drive them. Cancer and CVD are the world’s two leading killers, and together account for almost half of all lives lost. Historically considered distinct disorders, these diseases are now known to share several underlying biological mechanisms. Indeed, we and others have identified a wide range of commonalities across cancer and CVD, including common genetic variation, overlapping transcriptional perturbations, and conserved cellular changes related to plasticity and clonal expansion. Emerging evidence further highlights the bidirectional relationship between these diseases: cancer therapies, including chemotherapy and radiation, could contribute to cardiovascular toxicity, while CVD and its associated risk factors may promote tumorigenesis and cancer progression. Large-scale epidemiology efforts pioneered by our group also indicate that having one disease increases the risk for the other, even after adjusting for shared risk factors and cardiotoxic chemotherapy usage. Taken together, these findings present the provocative concept that one disease may directly increase the risk of the other. Despite these advances, the molecular pathways, modifiable risk factors, and predictive biomarkers underlying this interplay remain poorly understood. By utilizing UKBB, this research aims to identify novel risk factors and biomarkers that can inform early detection, prevention, and personalized treatment strategies for patients at the intersection of these two diseases, which has the potential to significantly improve patient outcomes and advance our understanding of the shared pathophysiology between cancer and CVD.
