A new observational study reports that cardiovascular-kidney-metabolic (CKM) syndrome is associated with an increased risk of cancer, with the risk rising as CKM stage worsens. The researchers say their findings support including cancer prevention in care for people with CKM syndrome, though the study cannot prove causation.
Study and main findings
Researchers analyzed insurance claims and health checkup data from nearly 1.4 million people in Japan collected between April 2014 and August 2023, with a median follow-up of just over three years. They compared cancer incidence by CKM stage and found increasing cancer risk at higher stages:
– Stage 1: 3% higher risk
– Stage 2: 2% higher risk
– Stage 3: 25% higher risk
– Stage 4: 30% higher risk
Stages were assigned based on the number and severity of CKM components (cardiovascular disease, kidney disease, metabolic dysfunction, hypertension, excess adiposity, abnormal blood sugar). The researchers note that the only statistically meaningful associations were for stages 3 and 4, and they emphasize that the observational design limits causal conclusions.
Shared mechanisms and overlapping risk factors
The team highlighted shared pathophysiological mechanisms linking CKM and cancer risk, including systemic inflammation, insulin resistance, oxidative stress, and excess or dysfunctional adipose tissue. They also pointed out overlapping risk factors — aging, smoking, alcohol use, poor diet, and other unhealthy lifestyle behaviors — that contribute to both CKM progression and cancer.
Expert perspectives
Independent experts said the study adds to evidence connecting cardiovascular, metabolic, and kidney disorders with cancer. Michael McConnell, MD (Stanford Medicine), noted that prior science shows large overlaps in risk factors for cardiovascular disease and cancer, and emphasized prevention. Christopher Berg, MD (MemorialCare), said the study may help identify at-risk patients but offers limited new prevention strategies beyond general health improvement; he advised focusing on measures that benefit heart health, which also reduce cancer risk. Tochi Okwuosa, DO (Rush University), emphasized inflammation as a likely common driver and described how obesity, insulin resistance, hypertension, and kidney disease can cascade into broader cardiometabolic harm.
Context and prevalence
The American Heart Association first described CKM syndrome in October 2023, recommending a multidisciplinary approach to prevention, screening, and treatment. A 2024 study in JAMA estimated that up to 90% of U.S. adults have at least some CKM components. In that earlier analysis, distribution by stage was roughly: 10% stage 0, 26% stage 1, 49% stage 2, 5% stage 3, and 9% stage 4. Stage 1 often reflects excess body fat and elevated blood sugar; stage 3 reflects subclinical cardiovascular issues and high-risk chronic kidney disease; stage 4 includes manifest cardiovascular disease and, in some subgroups, kidney failure.
Prevention and clinical implications
The researchers and commentators recommend that cancer risk be considered when assessing patients with CKM syndrome, particularly those in advanced stages. Early detection through appropriate cancer screening is important. Lifestyle measures that address shared risk factors can lower both cardiovascular and cancer risk. Recommended actions include:
– Healthy diet and reducing ultra-processed foods
– Regular physical activity
– Avoiding tobacco and limiting alcohol
– Managing weight, blood pressure, blood sugar, and kidney health
– Following guideline-recommended screenings and multidisciplinary care when appropriate
Experts suggest patients start with one or two achievable changes (for example, increasing activity and cutting ultra-processed food) and emphasize that therapies that improve cardiovascular, metabolic, and kidney health are increasingly effective and may also reduce cancer risk.
Limitations
Authors and external experts caution that the study’s observational nature and relatively short median follow-up (about three years) limit conclusions about causality and long-term risk. The stronger associations were seen in later CKM stages, supporting the view that shared risk factors and advanced cardiometabolic disease drive much of the observed cancer risk.
Bottom line
CKM syndrome is common and linked in this large observational study to modestly higher cancer risk that grows with disease stage, especially stage 3 and 4. The findings support integrating cancer prevention and screening into care for people with advanced CKM while reinforcing established prevention strategies: improve diet, increase physical activity, avoid tobacco and excess alcohol, and manage cardiovascular, metabolic, and kidney risk factors.
