Cancer and Atrial Fibrillation Comorbidities Among 25 Million Citizens in Shanghai, China - Medical Insurance Database Study

Q: What data source and study period were used to assess cancer and AF comorbidities in Shanghai?

The study screened records from the Shanghai Municipal Health Commission database covering all insured medical records of Shanghai residents between 2015 and 2020.

Q: How did cancer prevalence differ between residents with AF and those without AF?

Among adults, cancer with AF was 8.27% versus 6.05% without AF, with a higher prevalence in the AF group (P<.001).

Q: Which cancer types showed the largest increases in prevalence among people with AF?

The most prominent increases were for nonsolid tumors, including multiple myeloma (PR 2.56), leukemia (PR 1.73), and non-Hodgkin lymphoma (PR 1.59), along with notable intrathoracic malignancies such as mediastinum (PR 2.34) and lung (PR 1.64).

Q: What main clinical implication did the study conclude regarding patients with AF?

Patients with AF had increased cancer prevalence, greater male predominance, and younger peak cancer diagnosis age, suggesting the need to determine whether early screening for specific cancers is cost-effective and beneficial.

Sep 24, 2026

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Population aging has increased both cancer and atrial fibrillation (AF), yet reliable epidemiological evidence on their comorbidity in China has been limited. This study evaluated cancer–AF coexisting patterns by cancer site, sex, and age using Shanghai medical insurance records from 2015–2020. Among 25.96 million adults, cancer prevalence was higher with AF (8.27%) than without AF (6.05%), with a nearly 1.4-fold increase after adjustment and younger AF-associated cancer peak ages.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Background

Objective

Methods

Results

Conclusions

Introduction

JMIR PUBLIC HEALTH AND SURVEILLANCE Chen et al Original Paper Cancer and Atrial Fibrillation Comorbidities Among 25 Million Citizens in Shanghai, China: Medical Insurance Database Study | Mu Chen1*, MD; Cheng Li1*, MD; Jiwei Zhang2*, PhD; Xin Cui3, MS; Wenqi Tian3, MSc; Peng Liao4, PhD; Qunshan Wang1, MD; Jian Sun1, MD; Li Luo4, PhD; Hong Wu5, MD; Yi-Gang Li1, MD | | --- | | 1Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
2Shanghai Key Laboratory of Compound Chinese Medicines, The Ministry of Education Key Laboratory for Standardization of Chinese Medicines, Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai, China
3Shanghai Health Statistics Center, Shanghai, China 4School of Public Health, Fudan University, Shanghai, China 5Shanghai Municipal Health Commission, Shanghai, China
*these authors contributed equally
Corresponding Author:
Yi-Gang Li, MD
Department of Cardiology, Xinhua Hospital School of Medicine
Shanghai Jiao Tong University 1665 Kongjiang Rd, Yangpu District Shanghai, 200092
China
Phone: 86 21 25077275
Email: [liyigang@xinhuamed.com.cn](liyigang@xinhuamed.com.cn)
Abstract | Background: With population aging, the prevalence of both cancer and atrial fibrillation (AF) have increased. However, thereis scarce epidemiological data concerning the comorbid state of cancer and AF in low-and middle-income countries, including China. Objective: We aimed to evaluate the site-, sex-, and age-specific profiles of cancer and AF comorbidities in Chinese populations. Methods: Data from the Shanghai Municipal Health Commission database between 2015 and 2020 were screened, covering all medical records of Shanghai residents with medical insurance. Site-specific cancer profiles were evaluated for the population with AF relative to the age-and sex-adjusted population of residents without AF. The sex distribution and peak age of cancer diagnosis were also assessed. Results: A total of 25,964,447 adult patients were screened. Among them, 22,185 patients presented cancers comorbid with AF (median 77, IQR 67-82 years of age; men: n=13,631, 61.44%), while 839,864 presented cancers without AF (median 67, IQR 57-72 years of age; men: n=419,020, 49.89%), thus yielding a higher cancer prevalence among residents with AF (8.27%) than among those without AF (6.05%; P<.001). In the population with AF, the most prevalent cancer type was lung cancer, followed by colorectal, male genital organ, stomach, breast, liver, bladder, thyroid, leukemia, and esophageal cancers. AF was associated with an average of nearly 1.4-fold (prevalence ratio [PR] 1.37, 95% CI 1.35-1.38) increased prevalence of cancer after adjusting for age and sex. For site-specific analyses, an increased prevalence of cancer in the population with AF was observed in 20 of 21 cancer sites. This increased prevalence was most prominent for nonsolid tumors, including multiple myeloma (PR 2.56, 95% CI 2.28-2.87), leukemia (PR 1.73, 95% CI 1.57-1.90), and non-Hodgkin lymphoma (PR 1.59, 95% CI 1.43-1.77); intrathoracic malignancies, including mediastinum (PR 2.34, 95% CI 1.89-2.90), lung (PR 1.64, 95% CI 1.59-1.69), and esophageal cancers (PR 1.41, 95% CI 1.28-1.56); bone and soft tissue neoplasms (PR 1.56, 95% CI 1.37-1.77); and kidney cancer (PR 1.53, 95% CI 1.36-1.72) . Cancer prevalence in the population with AF relative to that in the population without AF was higher in men than in women in 14 of 18 cancer sites, and female predominance was only observed for thyroid cancer. The peak age of index cancer diagnosis was lower in the population with AF (age group: 70-74 years) than in that without AF (age group: 75-79 years), especially for specific cancer types, including thyroid, central nervous system, mediastinum, esophageal, bladder, and biliary cancers. [https://publichealth.jmir.org/2023/1/e40149](https://publichealth.jmir.org/

FAQs

What data source and study period were used to assess cancer and AF comorbidities in Shanghai?

The study screened records from the Shanghai Municipal Health Commission database covering all insured medical records of Shanghai residents between 2015 and 2020.

How did cancer prevalence differ between residents with AF and those without AF?

Among adults, cancer with AF was 8.27% versus 6.05% without AF, with a higher prevalence in the AF group (P<.001).

Which cancer types showed the largest increases in prevalence among people with AF?

The most prominent increases were for nonsolid tumors, including multiple myeloma (PR 2.56), leukemia (PR 1.73), and non-Hodgkin lymphoma (PR 1.59), along with notable intrathoracic malignancies such as mediastinum (PR 2.34) and lung (PR 1.64).

What main clinical implication did the study conclude regarding patients with AF?

Patients with AF had increased cancer prevalence, greater male predominance, and younger peak cancer diagnosis age, suggesting the need to determine whether early screening for specific cancers is cost-effective and beneficial.

Sep 24, 2026

Uploaded by Elsa