Association between cardiovascular disease and non-melanoma skin cancer - The mediation effect of obesity and inflammation

Sep 22, 2026

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Although links between cardiovascular disease (CVD) and many cancers have been examined, the connection with non-melanoma skin cancer (NMSC) remains unclear. This study evaluates whether obesity and inflammation mediate the association between CVD and NMSC. Using 7,424 NHANES participants (2015–2018), CVD and NMSC were identified by questionnaire and self-report, and obesity/inflammatory indices (SIRI, SII, BMI, WWI) were analyzed with logistic regression and correlation methods. Results show CVD as a risk factor and partial mediation by SIRI, BMI, and WWI, with bootstrap confirmation.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

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Abstract

Background

Methods

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Introduction

OPEN ACCESS Citation: Zhang X, Gao Z, Miao Y, Wu X-G (2026) Association between cardiovascular disease and non-melanoma skin cancer: The mediation effect of obesity and inflammation. PLoS One 21(3): e0343992. [https://doi](https://doi). org/10.1371/journal.pone.0343992 Editor: Zahra Cheraghi, Hamadan University of Medical Sciences, School of Public Health, IRAN, ISLAMIC REPUBLIC OF Received: April 9, 2025 Accepted: February 14, 2026 Published: March 23, 2026 Copyright: © 2026 Zhang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data availability statement: All data used in the paper can be accessed and downloaded from the website [https://wwwn.cdc.gov/nchs/](https://wwwn.cdc.gov/nchs/)[ ](https://wwwn.cdc.gov/nchs/)[nhanes/search/default.aspx](nhanes/search/default.aspx.)[.](nhanes/search/default.aspx.) Funding: The work was supported by Medical and Health Science Program of Zhejiang RESEARCH ARTICLE Association between cardiovascular disease and non-melanoma skin cancer: The mediation effect of obesity and inflammation Xin Zhang1‡, Zhe Gao1‡, Ying Miao2‡, Xin-Gang Wu1* 1 Department of Dermatology, Hangzhou Third People’s Hospital, Hangzhou, China, 2 Department of Dermatology, The Third Affiliated Hospital of Soochow University, Changzhou, China ‡ These authors are joint first authors on this work. * [wuxingang1986@126.com](wuxingang1986@126.com) Abstract Background Although the association between CVD and various cancers has been extensively studied, its relationship with NMSC remains ambiguous. Previous studies have shown that cardiovascular disease (CVD) is an independent risk factor for tumorigenesis. However, the relationship between CVD and non-melanoma skin cancer (NMSC) is unclear. The aim of this study is to investigate the potential relationship between CVD and NMSC and whether obesity and inflammation mediate the association. Methods 7424 participants from the National Health and Nutrition Examination Survey (NHANES) from 2015 to 2018 were included. Diagnosis of CVD and NMSC was determined by questionnaire combined with self-reported. Inflammatory markers and obesity indices assessed were SIRI, SII, BMI, and WWI. Logistic regression and Pearson correlation analyses were applied to investigate the relationship between the above key variables. Results Logistic regression results showed that CVD was a risk factor for NMSC (OR: 1.83, 95% CI: 1.01 ~ 3.34, p = 0.048); however, there was no statistically significant association between CVD subgroups and NMSC. In addition, SIRI, BMI, and WWI partially mediated the association between CVD and NMSC (p < .001), but SII did not alter the relationship (p > 0.05) . Bootstrap test confirmed the stability of the results of the mediation analysis. PLOS One | [https://doi.org/10.1371/journal.pone.0343992](https://doi.org/10.1371/journal.pone.0343992) March 23, 2026 1 / 16 Province (2025KY144), Preclinical study of novel EGCG lead compounds for the treatment of vitiligo (LTGY23H110001) and Mechanistic study on the regulation of exosomal microRNA by Chai Hu Shuo Liver Tang in vitiligo treatment (2023ZL124) . The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Conclusion CVD increases the risk of developing NMSC, and obesity and inflammation partially mediate the relationship. Weight loss and control of inflammation may be beneficial in reducing the prevalence of CVD and NMSC. Introduction Non-melanoma skin cancers (NMSCs) are the most common skin cancers. 99% of NMSCs are basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) [ 1] . Other rare tumours, such as sebaceous gland

FAQs

What was the main aim of this study?

To assess the potential relationship between cardiovascular disease (CVD) and non-melanoma skin cancer (NMSC), and to determine whether obesity and inflammation mediate that association.

How were CVD and NMSC identified in the analysis?

CVD and NMSC diagnoses were determined from questionnaire data combined with self-reported information in the NHANES cohort.

Which factors mediated the CVD–NMSC association?

SIRI, BMI, and WWI partially mediated the association between CVD and NMSC, while SII did not significantly change the relationship.

Sep 22, 2026

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