A systematic review and meta-analysis of cancer risk in patients with abdominal aortic aneurysm

Zhixiong Zhang; Chi Shu; Julin Wang; Huanrui Hu; Jichun Zhao; Bin Huang; Vidalack Vilayphone; Wenjie Zhao; Yazhou He; Yi Yang

doi:10.1016/j.jvs.2026.04.032

A systematic review and meta-analysis of cancer risk in patients with abdominal aortic aneurysm

J Vasc Surg. 2026 May 7:S0741-5214(26)01081-5. doi: 10.1016/j.jvs.2026.04.032. Online ahead of print.

Authors

Affiliations

¹ Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China; West China School of Clinical Medicine, Sichuan University, Chengdu, China.
² Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.
³ Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; Yu-Yue Pathology Scientific Research Center, Chongqing, China; Jinfeng Laboratory, Chongqing, China.
⁴ Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China. Electronic address: yangy@wchscu.cn.

PMID: 42102924
DOI: 10.1016/j.jvs.2026.04.032

Abstract

Objective: This systematic review and meta-analysis aim to determine whether patients with abdominal aortic aneurysm (AAA) have an elevated risk of developing cancer compared with those without AAA, and to compare the cancer risk among patients who have undergone different types of AAA repair.

Methods: This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search of PubMed, Embase, and Web of Science was performed up to August 27, 2025, to identify studies investigating cancer risk in patients with AAA. The primary objective was to determine whether the risk of cancer is higher in patients with AAA compared with those without AAA. The secondary objective was to compare the cancer risk among patients who underwent different AAA repair procedures. Two reviewers independently selected studies for inclusion and extracted the data. All statistical analyses were performed using standard statistical procedures in R software (The R Foundation for Statistical Computing).

Results: Twelve original studies were included. A significant association was observed between AAA and an elevated risk of cancer compared with those without AAA risk ratio ([RR], 1.69; 95% confidence interval, 1.28-2.22; P < .001). Subgroup analyses revealed associations with elevated risks of respiratory, hepatic, bladder, pancreatic, and hematological malignancies. Additionally, endovascular aortic repair was associated with a higher cancer risk compared with open aortic repair (risk ratio, 1.11, 95% confidence interval, 1.06-1.16; P < .001).

Conclusions: This meta-analysis suggests that AAA is associated with an increased cancer risk compared with the general population, and also suggests a higher cancer risk and/or a greater likelihood of cancer detection associated with endovascular aortic repair compared with open aortic repair.

Keywords: Abdominal aortic aneurysm; Abdominal aortic aneurysm repair; Cancer risk; Meta-analysis.

Publication types

Review