流行病学和机制数据支持心血管疾病（CVD）和癌症之间的潜在因果关系。腹主动脉瘤 (AAA) 是一种常见的 CVD 形式，其遗传和生物学病因至少部分不同于其他形式的 CVD。 AAA 患者患癌症的风险以及这种风险与其他形式的 CVD 有何不同尚不清楚。我们使用 IBM MarketScan 研究数据库进行了一项回顾性队列研究，以测试 AAA 患者是否具有较高的癌症风险，而与传统的共同风险因素无关。所有年龄≥18 岁且在 2008 年至 2020 年间连续承保 ≥36 个月的个体均被纳入研究。那些具有 AAA 潜在孟德尔病因、具有非特异性解剖位置的主动脉瘤或在随访开始前被诊断为癌症的患者被排除在外。对具有健康风险评估记录（包括烟草使用和体重指数）的个人进行亚组分析。对以下几组个体进行了比较：(1) 患有 AAA，(2) 患有非 AAA CVD，以及 (3) 没有任何 CVD。倾向评分匹配队列包括 58 993 名 AAA 个体，117 986 名非 AAA 个体CVD 和无 CVD 的 58 993。 AAA 参与者的 5 年累积癌症发病率为 13.1% (12.8%-13.5%)，非 AAA CVD 参与者为 10.1% (9.9%-10.3%)，非 AAA CVD 参与者为 9.6% (9.3%-9.9%)没有 CVD 的参与者。多变量调整的 Cox 比例风险回归模型发现，AAA 患者比非 AAA CVD 患者（风险比，1.28 [95% CI，1.23-1.32]；P<0.001）或无 CVD 患者表现出更高的癌症风险（风险比，1.32 [95% CI，1.26-1.38]；P<0.001）。在排除常见的与吸烟相关的癌症以及调整烟草使用和体重指数后，结果保持一致。AAA 患者可能具有独特的癌症风险，需要进一步的机制研究和加强癌症筛查作用的调查。

Epidemiological and mechanistic data support a potential causal link between cardiovascular disease (CVD) and cancer. Abdominal aortic aneurysms (AAAs) represent a common form of CVD with at least partially distinct genetic and biologic etiology from other forms of CVD. The risk of cancer and how this risk differs compared with other forms of CVD, is unknown among AAA patients. We conducted a retrospective cohort study using the IBM MarketScan Research Database to test whether individuals with AAA have a higher cancer risk independent of traditional shared risk factors.All individuals ≥18 years of age with ≥36 months of continuous coverage between 2008 and 2020 were enrolled. Those with potential Mendelian etiologies of AAA, aortic aneurysm with nonspecific anatomic location, or a cancer diagnosis before the start of follow-up were excluded. A subgroup analysis was performed of individuals having the Health Risk Assessment records including tobacco use and body mass index. The following groups of individuals were compared: (1) with AAA, (2) with non-AAA CVD, and (3) without any CVD.The propensity score-matched cohort included 58 993 individuals with AAA, 117 986 with non-AAA CVD, and 58 993 without CVD. The 5-year cumulative incidence of cancer was 13.1% (12.8%-13.5%) in participants with AAA, 10.1% (9.9%-10.3%) in participants with non-AAA CVD, and 9.6% (9.3%-9.9%) in participants without CVD. Multivariable-adjusted Cox proportional hazards regression models found that patients with AAA exhibited a higher cancer risk than either those with non-AAA CVD (hazard ratio, 1.28 [95% CI, 1.23-1.32]; P<0.001) or those without CVD (hazard ratio, 1.32 [95% CI, 1.26-1.38]; P<0.001). Results remained consistent after excluding common smoking-related cancers and when adjusting for tobacco use and body mass index.Patients with AAA may have a unique risk of cancer requiring further mechanistic study and investigation of the role of enhanced cancer screening.