Lifestyle Factors, Cardiometabolic Diseases, and Subsequent Cancer Risk: Evidence from Two Large Prospective Cohort Studies

Xia Zhu; Yuting Han; Qiufen Sun; Meng Zhu; Caiwang Yan; Canqing Yu; Dianjianyi Sun; Pei Pei; Yue Jiang; Jiaping Chen; Chunxiao Liao; Ling Yang; Yiping Chen; Huaidong Du; Juncheng Dai; Hongxia Ma; Zhengming Chen; Zhibin Hu; Jun Lv; Hongbing Shen; Liming Li; Guangfu Jin

doi:10.1016/j.eng.2026.07.009

Engineering ›› :202607009 DOI: 10.1016/j.eng.2026.07.009

research-article

Lifestyle Factors, Cardiometabolic Diseases, and Subsequent Cancer Risk: Evidence from Two Large Prospective Cohort Studies

Xia Zhu ^a^,^b^,^c^,^#
, Yuting Han ^d^,^#
, Qiufen Sun ^a^,^b^,^c^,^#
, Meng Zhu ^a^,^b^,^c
, Caiwang Yan ^a^,^b^,^c
, Canqing Yu ^d^,^e^,^f
, Dianjianyi Sun ^d^,^e^,^f
, Pei Pei ^e
, Yue Jiang ^a^,^b
, Jiaping Chen ^a^,^b
, Chunxiao Liao ^d^,^e^,^f
, Ling Yang ^g
, Yiping Chen ^g
, Huaidong Du ^g
, Juncheng Dai ^a^,^b
, Hongxia Ma ^a^,^b
, Zhengming Chen ^g
, Zhibin Hu ^a^,^b
, Jun Lv ^d^,^e^,^f^,^h
, Hongbing Shen ^a^,^b^,^*
, Liming Li ^d^,^e^,^f^,^*
, Guangfu Jin ^a^,^b^,^c^,^*

Author information +

^a Department of Epidemiology & Center for Global Health, School of Public Health, Nanjing Medical University , Nanjing 211166, China

^b State Key Laboratory Cultivation Base of Biomarkers for Cancer Precision Prevention and Treatment & Collaborative Innovation Center for Cancer Personalized Medicine & China International Cooperation Center for Environment and Human Health, Nanjing Medical University , Nanjing 211166, China

^cDepartment of Chronic Non—Communicable Disease Control, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University & Wuxi Center for Disease Control and Prevention & Wuxi Medical Center, Nanjing Medical University , Wuxi 214023, China

^d Department of Epidemiology and Biostatistics, School of Public Health, Peking University , Beijing 100191, China

^e Peking University Center for Public Health and Epidemic Preparedness and Response , Beijing 100191, China

^f Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education , Beijing 100191, China

^g Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford , Oxford OX3 7LF, UK

^h State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University , Beijing 100191, China

^*E-mail addresses:guangfujin@njmu.edu.cn (G. Jin),

lmlee@bjmu.edu.cn (L. Li),

hbshen@njmu.edu.cn (H. Shen).

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Abstract

Cardiometabolic diseases (CMDs) are associated with increased cancer risk; however, the role of healthy lifestyle factors (LFs) in mitigating this risk remains unclear. Using data from 856 568 adults in the China Kadoorie Biobank (n = 461 047) and the UK Biobank (n = 395 521), we prospectively examined the associations of CMDs and cardiometabolic multimorbidity (CMM) with subsequent cancer risk and evaluated the potential protective effects of five low-risk LFs: no tobacco smoking, no excessive alcohol drinking, high physical activity, healthy dietary habits, and healthy body shape. We demonstrated that individuals with CMDs, especially those with multimorbidity, faced a significantly higher risk of cancer in both cohorts. Healthy LFs, particularly no tobacco smoking and high physical activity, were associated with a lower cancer risk following CMD onset. Moreover, adopting at least four healthy lifestyles could prevent an estimated 11.50%–15.30% of cancer cases among those with CMD. These findings highlight the importance of lifestyle interventions in cancer prevention, particularly for those with preexisting cardiometabolic conditions.

Keywords

Lifestyle / Cardiometabolic disease

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Xia Zhu, Yuting Han, Qiufen Sun, Meng Zhu, Caiwang Yan, Canqing Yu, Dianjianyi Sun, Pei Pei, Yue Jiang, Jiaping Chen, Chunxiao Liao, Ling Yang, Yiping Chen, Huaidong Du, Juncheng Dai, Hongxia Ma, Zhengming Chen, Zhibin Hu, Jun Lv, Hongbing Shen, Liming Li, Guangfu Jin. Lifestyle Factors, Cardiometabolic Diseases, and Subsequent Cancer Risk: Evidence from Two Large Prospective Cohort Studies. Engineering 202607009 DOI:10.1016/j.eng.2026.07.009

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