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. 2014 Aug 13;9(8):e102861.
doi: 10.1371/journal.pone.0102861. eCollection 2014.

Atrial fibrillation as a marker of occult cancer

Eva B Ostenfeld  1 , Rune Erichsen  2 , Lars Pedersen  2 , Dóra K Farkas  2 , Noel S Weiss  3 , Henrik T Sørensen  2
Affiliations

Atrial fibrillation as a marker of occult cancer

Eva B Ostenfeld et al. PLoS One. .

Abstract

Background: Recent studies suggest that cancer increases risk of atrial fibrillation. Whether atrial fibrillation is a marker for underlying occult cancer is unknown.

Methods: We conducted a cohort study (1980-2011) of all Danish patients with new-onset atrial fibrillation. To examine cancer risk, we computed absolute risk at 3 months and standardized incidence ratios (SIRs) by comparing observed cancer incidence among patients newly diagnosed with atrial fibrillation with that expected based on national cancer incidence during the period.

Results: Median follow-up time was 3.4 years among 269 742 atrial fibrillation patients. Within 3 months of follow-up, 6656 cancers occurred (absolute risk, 2.5%; 95% confidence intervals [CI], 2.4%-2.5%) versus 1302 expected, yielding a SIR of 5.11; 95% CI, 4.99-5.24. Associations were particularly strong for cancers of the lung, kidney, colon, ovary, and for non-Hodgkin's lymphoma. The SIR within 3 months of follow-up was 7.02; 95% CI, 6.76-7.28 for metastatic and 3.53; 95% CI, 3.38-3.68 for localized cancer. Beyond 3 months of follow-up, overall cancer risk was modestly increased (SIR, 1.13; 95% CI, 1.12-1.15).

Conclusion: Patients with new-onset atrial fibrillation had a markedly increased relative risk of a cancer diagnosis within the next three months, however, corresponding absolute risk was small.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for all cancer sites following atrial fibrillation by follow-up period, Denmark, 1980–2011.
See this image and copyright information in PMC

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