title: Comprehensive analysis of clinico-pathological data reveals heterogeneous relations between atherosclerosis and cancer.
abstract: OBJECTIVE
  Atherosclerosis and cancer share common risk factors and involve similar molecular pathomechanisms. Most clinical and epidemiological studies show a positive correlation between atherosclerosis and smoking-related cancers and heterogeneous results for non-smoking-related cancers. However, up-to-date large-scale autopsy studies including a detailed analysis of cancer types are lacking. Therefore, we sought to investigate the relation between major cancer types and the grade of atherosclerosis in a recent well-powered autopsy cohort.
  
  
  METHODS
  In 2101 patients, both autopsy data and clinical data including demographics, disease groups, tumour type, cause of death and grade of atherosclerosis were reviewed and statistically analysed.
  
  
  RESULTS
  We found cancer in general is associated with less atherosclerosis (OR 0.60, p<0.0001). In particular, haematological neoplasm and sarcomas were associated with much less atherosclerosis (OR=0.45, p<0.0001 and OR=0.43, p=0.087), while carcinomas were associated with moderately less atherosclerosis (OR=0.72, p=0.002). Furthermore, non-smoking-related cancers were associated with much less atherosclerosis (OR=0.41, p<0.0001), while possibly smoking-related cancer and smoking-related cancer showed no significant association. In a comprehensive analysis of 21 cancer types, biliary tract cancer, lymphomas/lymphoid leukaemias and kidney cancer were associated with much less atherosclerosis (OR=0.19, p<0.0001; OR=0.41, p<0.0001; and OR=0.48, p=0.029). In an exploratory analysis of treatment strategies, we found that tumours with a recommendation of oxazaphosphorines and pyrimidine antagonist treatment were significantly associated with less atherosclerosis (OR=0.33, p=0.0068 and OR=0.58, p=0.012).
  
  
  CONCLUSIONS
  In conclusion, the study showed an inverse association between cancer and atherosclerosis postmortem that depends on the cancer type and suggests a possible impact of chemotherapy regimens.
authors: Institute of Pathology, Charité University Hospital, Berlin, Germany.
authors: Jan
authors: J
authors: Budczies
authors: Institute of Pathology, Charité University Hospital, Berlin, Germany.
authors: Moritz
authors: M
authors: von Winterfeld
authors: Institute of Pathology, Charité University Hospital, Berlin, Germany.
authors: Frederick
authors: F
authors: Klauschen
authors: Institute of Pathology, Charité University Hospital, Berlin, Germany.
authors: Anna-Christin
authors: AC
authors: Kimmritz
authors: Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
authors: Jan-Marcus
authors: JM
authors: Daniel
authors: Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.
authors: Arne
authors: A
authors: Warth
authors: Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.
authors: Volker
authors: V
authors: Endris
authors: Institute of Pathology, Charité University Hospital, Berlin, Germany.
authors: Carsten
authors: C
authors: Denkert
authors: Institute of Legal Medicine, University Hospital Münster, Münster, Germany.
authors: Heidi
authors: H
authors: Pfeiffer
authors: Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.
authors: Wilko
authors: W
authors: Weichert
authors: Institute of Pathology, Charité University Hospital, Berlin, Germany.
authors: Manfred
authors: M
authors: Dietel
authors: Institute of Legal Medicine, University Hospital Münster, Münster, Germany.
authors: Daniel
authors: D
authors: Wittschieber
authors: Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.
authors: Albrecht
authors: A
authors: Stenzinger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects; D050197:Atherosclerosis / Q000453:epidemiology / Q000473:pathology*; D001344:Autopsy; D001604:Berlin / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000145:classification / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D016017:Odds Ratio; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents
keywords: ARTERIES; CANCER; CANCER RESEARCH