As heart, kidney and metabolic health worsen, cancer risk may rise: Study
Stock image of doctor and patient. (Westend61/Getty Images)
(NEW YORK) — As heart, kidney and metabolic problems progress to more advanced stages, a person’s risk of developing several cancers also rises sharply, a new study finds.
Cardiovascular-kidney-metabolic (CKM) syndrome is a disorder that occurs when heart disease, kidney problems and metabolic issues including obesity and diabetes all happen together, according to the American Heart Association.
About one in three U.S. adults have at least three risk factors for CKM syndrome, the AHA says.
Researchers used a claims database in Japan that included individuals with available health check-up data and insurance claims between April 2014 and August 2023.
People diagnosed with stage 3 CKM syndrome at the start of the study were 25% more likely to be diagnosed with one of 16 different cancers four years later in comparison to those with early CKM syndrome, according to the study published Monday in the journal Circulation.
Those who were diagnosed with stage 4 CKM syndrome had a 30% increased likelihood of having a cancer diagnosis four years later. Those diagnosed with stage 1 or stage 2 of the condition had a less than 5% chance of cancer diagnosis in four years.
“The study findings suggest that it is important to consider not only cardiovascular disease risk, but also cancer risk in people with CKM syndrome,” Dr. Hidehiro Kaneko, the study’s lead author and associate professor in the department of cardiovascular medicine at the University of Tokyo in Japan, said in a press release.
The study results accounted for age, gender and lifestyle factors including smoking, alcohol use and weight.
Individual symptoms such as high blood pressure are often used to determine certain cancer risks, but this study used a more patient-centered classification such as CKM syndrome staging as a predictor for certain cancers, according to the authors.
“CKM syndrome represents a complex interplay among the cardiovascular, kidney and metabolic systems, where dysfunction in one area may trigger or exacerbate dysfunction in others,” Kaneko said.
“Dysfunction in each of these systems is independently associated with cancer risk due to shared risk factors,” he continued. “This study suggests that the accumulation of risk factors within the framework of CKM syndrome may contribute to the development of various types of cancer.”
Because the study is a retrospective observational study, meaning it analyzes existing data, it can only speak to association between CKM syndrome and certain cancers, not causality.
Additionally, because the study was conducted in Japan, which has a very homogenous population, further research would be needed to replicate the results among the U.S. population, which is more diverse.
(NEW YORK) — U.S. childhood and teen obesity rates have reached record-highs while adult obesity rates may be slowing, according to two new reports published early Wednesday by the Centers for Disease Control and Prevention (CDC).
Researchers used measured heights and weights from the National Health and Nutrition Examination Survey (NHANES) — run by the CDC’s National Center for Health Statistics — to track trends over more than six decades.
In the first report, the team found that, in the most recent survey conducted between August 2021 and August 2023, 40.3% of adults aged 20 and older were found to be obese, including 9.7% with severe obesity and another 31.7% classified as overweight.
By comparison, for the survey conducted between 1988 and 1994, 22.9% adults aged 20 and older were found to be obese including 2.8% with severe obesity and 33.1% classified as overweight.
However, some of the newest estimates suggest the rapid rise seen in earlier decades may be slowing slightly.
In the 2017-2018 survey, 42.4% of adults were classified as obese, which is the highest figure ever recorded. The decrease between the two most recent surveys could be indicative of a downward trend. Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital and an ABC News contributor, noted that it aligns with observations of electronic medical record data.
“So, we’re seeing, for the first time in decades, that there’s like a leveling off and even maybe a slight decrease and I think this is like challenging a major shift from the long-held expectation that obesity would just be climbing year after year,” he said.
According to Brownstein, the decrease is likely due to many factors including public health policies and education about healthier lifestyles as well as medications such as GLP-1s.
It can help produce more insulin, which reduces blood sugar and therefore helps control Type 2 diabetes. It can also interact with the brain and signal a person to feel full, which — when coupled with diet and exercise — can help reduce weight in those who are overweight or obese.
Many GLP-1s have become household names, including Ozempic, Wegovy, Mounjaro, Zepbound and Trulicity.
“I do think the advent of the GLP-1s are absolutely playing a role,” Brownstein said. “At that point in 2023, they weren’t as widespread as they are today. So, we expect that these factors could play even more significant role in more recent times.”
Dr. Justin Ryder, an associate professor of surgery and pediatrics at Northwestern Feinberg School of Medicine, said he’s cautiously optimistic about the slight decrease.
However, he added that it remains to be seen whether this is a blip or if the decrease is indicative of a longer-term trend.
“We’ve seen dips in the past and typically, when they do, in the next reporting period it goes right back up,” Ryder told ABC News. “And that’s because of how the sampling is done. This is a random sample of U.S. adults.”
He noted that the random sampling makes it difficult to draw firm conclusions.
“Could it just be the people who were sampled, or is it real?” he said. “And I think we won’t know that until we have another set or a larger set of data over either the same sampling period or a couple more years from now.”
Meanwhile, a second report found that more than one in five U.S. children and teenagers have obesity, which is the highest figure ever recorded.
The survey conducted between August 2021 and August 2023 found 21.1% of U.S. children and teenagers between ages 2 and 19 have obesity, up from 5.2% during the 1971-1974 survey.
Additionally, 7% of children live with severe obesity, an increase from the 1% seen 50 years ago, according to the report.
“This is exceptionally concerning,” Dr. David Ludwig, co-director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital and professor of nutrition at Harvard School of Public Health, told ABC News.
He added that in the 1970s, “children were certainly recognized [as obese] but it was the rare child, one in 20. And now we’re looking at one in five children with obesity.”
Ludwig said it had seemed for a short period of time that the prevalence of obesity was decreasing at least among 2-to-5-year-olds when rates declined from 12.1% in 2009-2010 to 9.4% in 2013-2014.
At the time, he viewed it as a “glimmer of hope” — but rates increased again and now sit at 14.9% for this age group.
“We saw that dip and we all got excited thinking that we were beginning to turn the tide,” Ludwig said. “In retrospect, that was more of a statistical aberration, more of mirage than a true glimmer of hope because the trend overall has continued upward.”
To reverse the trends among children, Ryder said the 2-to-5-year-old group will need lifestyle modifications such as healthier eating. The 6-to-11-year-old group will need similar methods although some medications are available, he said.
For children above age 12, Ryder said medications and bariatric surgery are options.
Nearly 23% of children ages 12 to 19 were considered obese in the most recent survey. Ryder said that means they meet the guidelines for intensive treatment, whether that’s lifestyle adjustments or in combination with medications or surgery.
“I think the only way that we’re going to see a downward trend in that number is if we take that adolescent group of 12- to 19-year-olds and actually start to apply the clinical practice guidelines and treat those kids seriously, offering them medications,” he said.
Ishani D. Premaratne, MD, is an integrated plastic & reconstructive surgery resident and member of the ABC News Medical Unit.
Abortion rights protesters chant slogans during a gathering to protest the Supreme Court’s decision in the Dobbs v Jackson Women’s Health case on June 24, 2022 in Jackson Hole, Wyoming. (Natalie Behring/Getty Images)
(NEW YORK) — Two bills having to do with abortion are making their way through the Wyoming legislature.
The first bill, HB0126, dubbed the Human Heartbeat Act, prohibits abortion if cardiac activity is detected in the fetus, which is around six weeks of pregnancy, before many women know they’re pregnant.
If cardiac activity is detected, an abortion can only be performed in the case of a medical emergency, meaning if the life of the mother is in danger or if continuing the pregnancy would cause serious or irreversible impairment of a major bodily function, according to the bill, which does not include exceptions for women impregnated as a result of rape or incest.
Any person who intentionally or knowingly violates the act will be charged with a felony punishable by up to five years in prison, a fine of up to $10,000, or both, according to the bill.
“What this bill attempts to do is to provide a line in the sand,” Republican Speaker of the House Rep. Chip Neiman said at a Wyoming House Labor, Health & Social Services Committee meeting on Monday. “This gives the unborn child the right to be protected and the privilege of being carried to term after a fetal heartbeat is detected.”
The bill also asserts that “substantial medical evidence” shows that a fetus can experience pain by 15 weeks of gestation.
“The science conclusively establishes that a human fetus does not have the capacity to experience pain until after at least 24–25 weeks,” according to the American College of Obstetricians & Gynecologists (ACOG).
The other bill, HB 117 or “Stop harm-empower women with informed notices,” requires medical professionals to give pregnant women written notices before performing an abortion.
The notice would include a description of the proposed abortion method, if there are medical risks associated with the method, alternatives such as adoption and parenting, and the medical risks associated with carrying the fetus to term
Patients who feel they’ve been coerced into receiving an abortion would be allowed to sue any providers for not less than $25,000.
The bill also includes text about the abortion drug mifepristone, including putting in the written notice that mifepristone alone is not always effective in ending a pregnancy. The written notice must also include that pregnant women should consult a health care provider if, after taking mifepristone, they regret their decision “to determine if there are options available to assist her in continuing her pregnancy.”
ACOG states that medication abortion “reversal” is not supported by science and that so-called reversal procedures are “unproven and unethical.”
Earlier this week, the Wyoming House Labor, Health & Social Services Committee recommended that both bills be passed. The bills will now go to the Wyoming State House for debate, amendment and voting.
Currently, abortion is allowed in Wyoming until fetal viability, which occurs at around 25 weeks of gestation, according to ACOG, defined as a fetus’ chances of surviving outside of the womb.
Only physicians are allowed to provide abortions in Wyoming, and they are required to submit a report to the Wyoming Department of Health within 20 days of any abortion procedure, according to the Guttmacher Institute, a research group that focuses on sexual and reproductive health.
In 2023, Wyoming passed two abortion bans. However, the Wyoming Supreme Court ruled in January that the bans were unconstitutional, violating a “health care freedom” amendment to the state constitution that was passed in 2012 that states in part that “each competent adult shall have the right to make his or her own health care decisions,” and that “the parent, guardian or legal representative of any other natural person shall have the right to make health care decisions for that person.”
During his State of the State address earlier this month, Wyoming Gov. Mark Gordon suggested that voters should decide on the issue.
“There’s another arduous task that I bring before you, which is the issue of abortion,” he said. “Protecting life is the most serious responsibility entrusted to government. The question of abortion deserves careful deliberation and I urge this legislature to take up this issue earnestly and put forward a genuine solution to the voters of Wyoming that provides a clear, irrefutable, durable, and morally sound resolution to this fraught issue.”
(NEW YORK) — As many as 724,000 service members, their families and veterans may rely on health care at hospitals that face financial vulnerability, partly due to cuts in President Donald Trump’s megabill, according to a new analysis.
The bill, known as HR.1, was signed into law in last summer and included sweeping changes to health care including Medicaid. Strict work requirements, reduced federal funding and tightening provider tax rules impacts hospitals that are dependent on Medicaid, increasing their risk of uncompensated care and reducing revenue.
Service members and their families — many of whom are covered by the military health insurance program TRICARE — rely heavily on civilian hospitals for health care, particularly in areas without military treatment facilities.
The analysis, conducted by researchers the Healthcare Quality and Outcomes Lab at Harvard’s T.H. Chan School of Public Health (HSPH) and first viewed by ABC News, looked at how many TRICARE beneficiaries may be reliant on hospitals considered at risk of financial distress under these new changes.
The researchers said many hospitals rely so heavily on Medicaid reimbursements that cuts to the program under HR.1 will affect care the hospitals provide to other patients, including those in the military community.
“We wanted to get a sense of how many hospitals are potentially at risk for becoming potentially financially unstable with the upcoming looming HR.1 Medicaid cuts,” Dr. Jose Figueroa, co-author of the analysis and associate professor of Health Policy and Management at HPSH told ABC News. “There’s a big focus on rural hospitals, but it is not just rural hospitals at risk, that we were finding that across the country, many urban hospitals are at risk.”
Figueroa said medical services that many TRICARE beneficiaries need are often only offered in civilian hospitals or in civilian health care systems. These beneficiaries are then exposed to hospitals that are potentially at financial risk, he noted.
“Military active duty service members on TRICARE and their families also on TRICARE are increasingly relying on civilian hospitals for their care, even when they’re living within a military base,” Figueroa said. “If we’re finding evidence that there are many hospitals across the country that are at risk, to what extent will that affect military personnel and their families?”
TRICARE is run by the U.S. Department of Defense for those connected to the military, including active duty members, National Guard and reserve members, military retirees and their families. It is not the same as Medicaid, although some may qualify for both.
For their analysis, the team used three different criteria to identify a hospital that might be at risk.
If more than one in four of patients being treated at the hospital are on Medicaid, given that the HR.1. cuts are disproportionally affecting those on the federal health insurance program. If the hospital is a safety net hospital, which serves a large number of patients with no insurance or with Medicaid, or a critical access hospital, which is a rural facility that provides essential health care services to underserved communities. The Altman Z-score, which is an aggregate measure of the financial health of a hospital, combining liquidity, profitability, financial efficiency and solvency measures to categorize a hospital as being at risk for bankruptcy. About 4% of hospitals were considered at higher risk of financial distress — meeting three of the criteria and about 19% were at moderate risk of financial distress — meeting two — according to the analysis.
The team then used a dataset to help to identify 8.9 million TRICARE beneficiaries and their ZIP codes.
The analysis estimated that more than 117,000 TRICARE beneficiaries are currently living on or near military installations potentially exposed to a hospital at higher risk of financial distress. Additionally, more than 607,000 are living near a hospital with a moderate risk of financial distress.
This means that more than 724,000 TRICARE beneficiaries are living in military installation ZIP codes — including bases, camps, posts, depots and stations — where at least one hospital has multiple risk factors for financial distress.
Additionally, more than 3.5 million TRICARE beneficiaries living in ZIP codes without a military installation are potentially exposed to a higher-risk or moderate-risk hospital, the analysis found.
“As a country, we should do our best to take care of the people protecting us,” Figueroa said. “Military personnel and their family members should be protected, and sometimes we have to remind ourselves that drastic cuts to our health care that affect our health delivery system also affects our active military personnel and their families as well.”
Last month, during a Senate hearing, Chief Master Sergeant of the Air Force David Wolfe said troops were struggling to get health care appointments and made reference to issues with TRICARE’s reimbursement rate for providers.
“What we’ve all seen over the length of our careers is a gradual erosion in the availability of that health care for our service members and their families,” Wolfe said, according to the Military Times.
Based on the results of the Harvard analysis, Sen. Elizabeth Warren, D- Mass., is launching an investigation into how the Pentagon is guiding military families through health care cuts and whether Republicans and the Trump administration consulted the Pentagon before the cuts were made, her office told ABC News first.
Warren is also pressing the Pentagon to explain how these cuts are affecting military readiness.
“Donald Trump is putting troops’ lives on the line in the Middle East while ripping away health care from their families at home,” Warren said in a statement to ABC News. “Republicans swore the Medicaid cuts in their Big Beautiful Bill were about cutting waste, fraud, and abuse — is that what they think of our military families’ health care?”
In a statement sent to ABC News, the Pentagon didn’t address Warren’s comments.
“As with all congressional correspondences, the Department will respond directly to the authors as appropriate,” a spokesperson said.
A Pentagon official also said it wouldn’t be appropriate to comment on the methodology of studies not conducted by the department.
The White House didn’t respond to ABC News’ request for comment.
