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논문분류	춘계학술대회 초록집
제목	Cardiovascular-Kidney-Metabolic Stages and Risk of 24 Site-Specific Cancers in 4.5 Million Korean Adults: A Nationwide Health Screening Cohort Study
저자	Ara Ko
출판정보	2026; 2026(1):
키워드	Cardiovascular-Kidney-Metabolic syndrome, Cancer, Epidemiology, Risk stratification, Metabolic health
초록	Objectives: Cardiovascular, kidney, and metabolic (CKM) conditions share a common pathological ground, yet their collective impact on cancer is often examined in isolation. However, whether this integrated metric is associated with cancer risk needs additional investigation. We aimed to evaluate the association between CKM staging and site-specific cancer risks in a population-scale nationwide cohort. Methods: We analyzed 4,454,232 adults using the Korean National Health Insurance Service database. CKM status was categorized into stages 0–4, ranging from no risk factors to symptomatic cardiovascular disease. Multivariable Cox proportional hazards models estimated the hazard ratios (HRs) for overall and 24 site-specific cancers, adjusting for sociodemographic and lifestyle factors. Results: During a median follow-up of 10.0 years, 302,218 incident cancer events were identified. Advanced CKM stages (3 and 4) were associated with a modest increase in overall cancer risk (adjusted HR 1.04; 95% CI 1.02–1.06) compared with stage 0. Site-specific analyses revealed distinct patterns. A “metabolically sensitive” cluster—including renal, liver, colorectal, pancreatic, and leukemia—showed consistent positive associations with CKM stages. Renal cancer exhibited the strongest association, with risk more than doubling in stage 4 CKM (adjusted HR 2.19; 1.88–2.55). In contrast, hormone-related and biliary cancers showed risk attenuation in advanced stages, whereas respiratory and upper gastrointestinal cancers exhibited inverse associations after adjustment. Conclusion: This large-scale study suggests that CKM staging is associated with heterogeneous site-specific cancer risk profiles. Our findings support stage-adapted surveillance, prioritizing metabolically sensitive tumors while adopting a tailored approach for other malignancies in advanced CKM stages.
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