Study Links Alcohol and Smoking to Higher Rates of Breast Cancer and Atrial Fibrillation in Older Women Worldwide

A global analysis published today in the Journal of the American Heart Association has found that alcohol consumption and smoking are significant shared risk factors for both breast cancer and atrial fibrillation (AFib) in women aged 55 and older, with similar rates of the two conditions occurring in about 40% of countries studied.

Researchers evaluated data from the Global Burden of Disease 2021 database covering 204 countries and territories, focusing on women ages 55 and older. They examined exposure to 58 health, behavioral and lifestyle risk factors. The study used machine learning to map global patterns and identify region-specific risk drivers.

The analysis found that in 80 of 202 countries (39%), rates of breast cancer and atrial fibrillation were similar. High-income and developed nations—including the United States, Canada, Australia, New Zealand and much of Europe—exhibited elevated rates of both conditions. High-risk zones were predominantly in Western countries, where exposure to smoking and alcohol use was greater compared to Eastern regions.

“One of the most surprising aspects of our findings was how common both breast cancer and atrial fibrillation/flutter diagnoses were among women ages 55 and older in high-income regions, which highlights the influence of lifestyle,” said study co-author Shu Wang, M.D., Ph.D., director of the Breast Disease Center at Peking University People’s Hospital in Beijing.

After accounting for multiple variables, smoking and alcohol use were linked to higher rates of both diseases. An additional analysis suggested that reducing alcohol intake and smoking could potentially lower the risk of breast cancer by about 15% and the risk of atrial fibrillation by about 12% worldwide. Alcohol use was found to contribute to 9.27% of breast cancer cases and 7.57% of atrial fibrillation cases.

“Breast cancer and atrial fibrillation/flutter rise together across many regions of the world and share the same modifiable risk factors,” said co-authors Zeye Liu, M.D., Ph.D., and Yi Shi, M.D., Ph.D., both of Peking University People’s Hospital. “From a cardiovascular perspective, this means that reducing smoking and alcohol use could help lower the risk of both conditions at the same time.”

The findings align with previous American Heart Association statements, including a 2018 Scientific Statement that identified shared risk factors between breast cancer and cardiovascular disease. Laxmi Mehta, M.D., FAHA, chair of the American Heart Association’s Council on Clinical Cardiology, who was not involved in the study, noted that “many of the same modifiable factors—including smoking, alcohol use, poor diet, physical inactivity and obesity—contribute to both breast cancer and cardiovascular disease including atrial fibrillation.” She emphasized the importance of integrated lifestyle strategies as outlined in the Association’s Life’s Essential 8.

The study created spatial risk maps to guide region-specific prevention strategies. Researchers plan to incorporate long-term data, genetic and metabolic factors, and socioeconomic variables in future work. Study limitations include the use of country-level data, which lacks individual-level detail and cannot prove cause and effect.

“Identifying shared risk factors is important for developing interventions that support optimal health, such as smoking cessation and alcohol restriction, which could potentially reduce the global incidence of breast cancer and atrial fibrillation/flutter substantially,” Wang said.

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