Key Insight: A large Japanese study suggests that individuals with advanced CKM syndrome face a significantly higher risk of developing cancer, while new guidelines aim to revolutionize early screening and care.
Study Finds Link Between Advanced CKM Syndrome and Increased Cancer Risk
Study Scope and Population
Researchers at the University of Tokyo analyzed data from a Japanese claims database encompassing nearly 1.4 million adults over an average period of approximately 3.5 years (April 2014 to August 2023). The study was retrospective and observational in nature.
Key Results
Compared to individuals with no CKM risk factors (Stage 0), the increased risk of developing one of 16 different cancers at a four-year follow-up was as follows:
- Stage 1: 3% higher risk
- Stage 2: 2% higher risk
- Stage 3: 25% higher risk
- Stage 4: 30% higher risk
Adjustments and Methodology
The results were adjusted for factors including age, sex, smoking, alcohol use, and weight. The study utilized the American Heart Association's four-stage CKM syndrome staging framework (Stage 1: overweight/obesity or prediabetes; Stage 4: diagnosed cardiovascular disease with metabolic risk factors or kidney disease).
Limitations
The study was conducted in Japan with a homogeneous population, which may limit the generalizability of the findings to more diverse populations. The study demonstrates an association, not causation.
Statements from Researchers
Lead author Dr. Hidehiro Kaneko stated the findings suggest that cancer risk should be considered in people with CKM syndrome in addition to cardiovascular risk.
Dr. Tochukwu Okwuosa noted that the study highlights a bidirectional relationship between cardiovascular disease and cancer.
First-Ever Clinical Practice Guideline for CKM Syndrome Published
Overview
The American Heart Association, the American College of Cardiology, and two other medical organizations have issued the first clinical practice guideline for cardiovascular-kidney-metabolic (CKM) syndrome.
Guideline Content
- Staging: Defines four stages of CKM syndrome to assess kidney, metabolic, and heart function.
- Risk Assessment: Recommends using the Predicting Risk of cardiovascular disease EVENTs (PREVENT) equations to estimate a patient's 10- and 30-year risk for cardiovascular disease.
- Social Screening: Recommends screening for social determinants of health, such as food insecurity, housing instability, and financial strain.
- Treatment: Includes recommendations for lifestyle modifications, medications (including GLP-1-based therapies and SGLT2 inhibitors), and metabolic/bariatric surgery when appropriate.
Prevalence of CKM Risk Factors
The guideline notes that nearly 90% of U.S. adults have at least one CKM syndrome risk factor. These include excess weight, high blood pressure, abnormal lipids, high blood glucose, or reduced kidney function. Specifically, 40% of U.S. adults and 21% of children and adolescents have obesity.
Statements from Guideline Authors
Chiadi E. Ndumele, M.D., Ph.D., M.H.S., FAHA, chair of the guideline writing committee: "This guideline calls for earlier screening and care, focusing on prevention and coordinated action to reduce the risk of cardiovascular disease before serious complications develop."
Fátima Rodriguez, M.D., M.P.H., FAHA, FACC, vice chair of the writing committee: "Life's Essential 8 focuses on regular physical activity, heart-healthy eating, maintaining a healthy weight, managing blood pressure, blood sugar and cholesterol, as well as avoiding tobacco and getting enough quality sleep."
Publication and Endorsement
The guideline was published in the journals Circulation and JACC on June 9, 2026. It is endorsed by the American Diabetes Association, the American Diabetes Association Obesity Association, and the American Society of Nephrology.