Existing Cardiovascular Risk Calculators Predict Several Common Cancers

Cardiovascular risk calculators are embedded in primary and secondary care to estimate 10‑year risk of heart attack or stroke from factors such as age, body mass index, and smoking. Many of these same factors are linked to cancer risk, yet routine tools to target cancer prevention remain limited. Identifying individuals at elevated risk could support earlier interventions during midlife. A new study shows these heart risk tools predict certain cancers about as well as they predict cardiovascular events.

Researchers at University College London evaluated whether widely used cardiovascular calculators can be repurposed to estimate cancer risk. The study, published in the European Journal of Cancer, assessed performance for both any cancer and specific tumor types. The investigation focused on adults aged 40 to 84 and examined how predictions aligned with real‑world outcomes over a decade.

The analysis covered four tools used in general practice and hospital settings: QRISK3 in the United Kingdom, the Pooled Cohort Equations in the United States, and SCORE2 and SCORE2‑OP in Europe. Investigators tested these models using anonymized records from UK Biobank and from general practices across the UK. More than five million people were included, enabling comparisons between predicted risks and observed cases of heart disease and cancer over 10 years.

The tools estimated risk for common cancers, including bowel, prostate, and breast cancer, about as well as a specialist cancer risk calculator. For several other cancers—kidney, laryngeal (throat), and gastro‑oesophageal (stomach and gullet)—the calculators performed about the same or better than they do when predicting heart attack and stroke. Their predictions were not perfect in either domain, yet they provided clinically meaningful stratification across multiple malignancies.

After age and sex, the most influential QRISK3 factors for cancer risk were smoking status and blood pressure. The researchers noted that high blood pressure may not directly cause cancer, but is likely associated with behaviors that raise cancer risk, such as physical inactivity and excessive alcohol intake. This risk‑factor overlap explains why cardiovascular calculators can carry signal for malignancy risk.

QRISK3 is integrated into general practitioner and hospital systems throughout the UK and forms part of England’s NHS Health Check for adults aged 40 to 74. People with a 10% or higher 10‑year cardiovascular risk are typically offered statins, sometimes blood pressure‑lowering medication, and lifestyle advice.

“More and more evidence is emerging that many cancers can potentially be prevented. Detecting cancer early through screening is important and is what health systems currently focus on, but there is also more we could do to prevent cancer from developing in the first place,” said Dr Sam Quill, a PhD student at the UCL Institute of Cardiovascular Science.

“In the UK, we currently offer statins to people at higher risk of heart disease using the QRISK3 tool. Our study suggests the risk of certain cancers could be estimated at the same time. However, the value of these tools in cancer prevention needs to be weighed carefully against wider efforts to reduce cancer risk for everyone. More research is needed to explore which approach and which interventions work best,” added Quill.

Related Links
UCL Institute of Cardiovascular Science