When Dr. Sam Quill started looking at heart disease calculators, the last thing the UCL researcher expected to find was a potential new tool for cancer prevention. But that's exactly what happened.
Quill and colleagues at University College London discovered that the same calculators doctors use to estimate heart attack and stroke risk can also predict certain cancers — and they do it almost as well as specialized cancer tools. The study, published in the European Journal of Cancer, analyzed data from more than 5 million people across the UK.
The four tools tested were QRISK3, used widely in the UK; the Pooled Cohort Equations, used in the US; and SCORE2 and SCORE2-OP, used in Europe. These tools estimate a person's percentage risk of having a heart attack or stroke over 10 years based on factors like age, BMI, and smoking status. The UCL team found that the same factors also work well for predicting some cancer types.
Among adults ages 40 to 84, the tools estimated the risk of colorectal, prostate, and breast cancers about as well as a dedicated cancer risk calculator. For other cancers — including kidney, throat, and stomach cancers — they performed just as well or even better than they do for heart disease.
"More and more evidence is emerging that many cancers can potentially be prevented," Quill said. "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."
In the UK, QRISK3 is already built into primary care and hospital computer systems. It is used during the NHS Health Check, a free heart-health screening offered every five years to adults ages 40 to 74. People flagged as high risk — defined as having a 10 percent or greater chance of heart attack or stroke over 10 years — are typically offered statins, blood pressure medication, and advice on healthy living.
The study found that after age and sex, smoking status and blood pressure were the most powerful predictors of cancer risk. Quill noted that high blood pressure may not cause cancer directly, but it tends to be linked to other risk factors like physical inactivity and heavy drinking.
The findings suggest doctors could potentially estimate cancer risk at the same time they assess heart risk, without extra tests or appointments. However, Quill cautions that more research is needed before this becomes standard practice. The value of using these tools for cancer prevention must be carefully weighed against broader efforts to reduce cancer risk for everyone.
"In the UK, we currently offer statins to people at higher risk of heart disease using the QRISK3 tool," Quill said. "Our study suggests the risk of certain cancers could be estimated at the same time. However, more research is needed to explore which approach and which interventions work best."