Abstract Body: Introduction: Skin cancer and cardiovascular disease (CVD) share pathophysiological mechanisms, including inflammation, endothelial dysfunction, and metabolic dysregulation. While cancer patients often exhibit increased CVD risks, the association between skin cancer and CVD remains limited. This study examines cardiovascular comorbidities in individuals with a history of skin cancer and assesses the impact of race, sex, and education.

Hypothesis: We hypothesize that individuals with skin cancer have a higher prevalence of cardiovascular comorbidities compared to controls, independent of demographic and socioeconomic factors.

Methods: The 2023 National Health Interview Survey was used to identify participants with a self-reported skin cancer diagnosis. Demographic variables and seven CVD comorbidities (hypertension, hyperlipidemia, coronary artery disease [CAD], angina, heart attack, stroke, and low-dose aspirin usage) were extracted. Survey weights were applied in R (4.3.3). Wilcoxon rank-sum and Rao-Scott chi-squared tests were used, followed by adjusted logistic regression.

Results: Among 8,633,462 individuals with skin cancer and 245,342,589 controls, skin cancer was independently associated with hyperlipidemia (OR 1.22, 95% CI 1.06-1.40), CAD (OR 1.26, 95% CI 1.03-1.55), and aspirin therapy (OR 1.19, 95% CI 1.03-1.38). Hypertension, angina, heart attack, and stroke were significantly associated (p < 0.001) but not independently. Older age and lower income increased CVD risk (ORs: 1.05-1.07, 1.10-2.34), while female sex reduced risk (ORs: 0.47-0.86). College education was linked to lower hypertension (OR 0.88), heart attack (0.82), and aspirin therapy (0.87).
In skin cancer patients, Asians had lower odds of CAD, angina, heart attack, stroke, and aspirin therapy (ORs: 0.44-0.62). Hispanics had higher odds of hyperlipidemia (1.12) but lower heart attack risk (0.45). Black participants had higher hypertension odds (1.76) but lower hyperlipidemia, CAD, and heart attack odds (0.63-0.80).

Conclusions: Skin cancer is significantly associated with cardiovascular comorbidities, particularly hyperlipidemia and CAD. These findings highlight the role of endothelial dysfunction and dyslipidemia in cancer-related CVD risk and support integrating cardiovascular screening into dermatologic practice. Limitations include self-reported data and cross-sectional design, necessitating prospective studies for validation.