Summary: A large, nationwide population-based cohort study using one of the world’s largest healthcare registries has uncovered a specific biological association between neovascular age-related macular degeneration (nAMD) and an elevated risk of several particular cancers. The research followed 334,091 people aged 50 and older — including 83,742 patients with nAMD and 250,349 matched controls — for up to 10 years. Rather than indicating a broad increase in all malignancies, the results show a selective pattern of cancer susceptibility in people with nAMD.
Key Facts
- Large-scale, long-term data: The study used a national insurance database to follow more than 330,000 individuals over a decade, giving the analysis strong statistical power to detect meaningful associations.
- Selective cancer risk: Increased risk was restricted to a subset of cancers: thyroid, kidney (renal), pancreatic, lung, bladder, and prostate. Many other common cancers showed no statistically significant association with nAMD.
- Notable thyroid association: One of the strongest links was with thyroid cancer; nAMD patients had about a 24% higher risk compared with matched controls.
- VEGF and its limits: Both nAMD and many tumors exploit vascular endothelial growth factor (VEGF)-driven angiogenesis. However, because most nAMD therapy uses localized anti-VEGF injections into the eye, shared VEGF signaling alone does not fully explain the systemic cancer associations identified.
- Shared aging-related biology: Investigators highlight a common aging–inflammation–vasculature axis that includes chronic low-grade inflammation, cellular senescence, oxidative stress, and changes to the extracellular matrix as likely contributors to both retinal degeneration and tumor susceptibility.
- Genetic overlaps: Emerging genetic evidence suggests overlapping hereditary risk factors in pathways such as complement activation, lipid metabolism, and tissue regulation that may predispose people to both nAMD and certain cancers.
- No recommendation for extra screening: The authors emphasize that the observed increases are modest. An nAMD diagnosis does not justify intensive, nonstandard cancer screening; routine, age-appropriate surveillance remains appropriate.
Source: Impact Journals
Neovascular age-related macular degeneration (nAMD) is a leading cause of severe vision loss in older adults. While its primary effects are retinal, growing evidence suggests nAMD often reflects systemic processes linked to aging — including vascular dysfunction, chronic inflammation, and immune dysregulation — that are also implicated in cancer development.
To investigate whether retinal degeneration and cancer risk are biologically linked, the researchers analyzed records from the Korean National Health Insurance Service. The cohort included 334,091 adults aged 50 and over, with 83,742 diagnosed with nAMD and 250,349 matched controls. Participants were monitored for up to 10 years, enabling assessment of both overall cancer incidence and cancer-type–specific risks.
Overall, people with nAMD experienced a modest but statistically significant increase in cancer risk compared with matched controls. Importantly, this increase was not uniform across all malignancies. Statistically significant elevations were found for pancreatic, lung, thyroid, renal (kidney), bladder, and prostate cancers, while many other cancer types showed no significant association.
Quantitatively, the adjusted hazard ratios reported indicate modest increases: for example, thyroid cancer risk was about 24% higher in the nAMD group. Similar but smaller increases were observed for pancreatic, lung, renal, bladder, and prostate cancers. These findings point toward a selective pattern of vulnerability rather than a generalized cancer predisposition in people with nAMD.
The team examined potential biological explanations. Angiogenesis is one shared feature: both nAMD and many aggressive tumors depend on angiogenic signaling, particularly via VEGF. However, anti-VEGF therapy for nAMD is delivered directly into the eye and generally remains localized; the study therefore concludes that VEGF-related mechanisms alone cannot account for the systemic cancer associations.
Instead, the authors propose a broader aging-related framework. Chronic low-grade inflammation, cellular senescence (accumulation of nondividing cells), oxidative damage, immune dysregulation, and remodeling of the extracellular matrix are processes that can accelerate tissue degeneration and contribute to tumor formation. Genetic overlaps in pathways regulating complement activation, lipid metabolism, and tissue homeostasis further support the idea of shared vulnerabilities.
The study’s authors caution that these associations should be interpreted carefully. Although statistically robust, the increased cancer risks are modest at the individual level and do not warrant altering current cancer screening guidelines solely because someone has nAMD. Instead, nAMD may function as a clinical signal of systemic aging processes that modestly raise the likelihood of selected cancers.
Key Questions Answered:
A: No. The study identifies a modest statistical correlation, not a direct cause. For any individual, the absolute increase in cancer risk remains small. The findings are primarily important for understanding shared biological pathways between aging-related diseases.
A: No. The study’s authors advise against extra, intensive cancer screening based solely on an nAMD diagnosis. Continue routine, age-appropriate screenings and discuss any concerns with your primary care physician.
A: Anti-VEGF treatments for nAMD are injected into the eye and act locally; they do not circulate at therapeutic levels throughout the body. Moreover, the study suggests shared systemic mechanisms beyond VEGF, including genetic predispositions and chronic inflammation.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- The journal paper was reviewed in full.
- Additional context was added by staff.
About this cancer and visual neuroscience research news
Author: Ryan Braithwaite
Source: Impact Journals LLC
Contact: Ryan Braithwaite – Impact Journals LLC
Image: The image is credited to Neuroscience News
Original Research: Open access. “Systemic cancer risk profile in neovascular age-related macular degeneration: insights into shared aging-related mechanisms from a nationwide population-based study” by Hyeong Min Kim, Yoonjong Bae, Mina Kim, Hyungwoo Lee, and Hyewon Chung. Aging-US. DOI: 10.18632/aging.206383
Abstract
Systemic cancer risk profile in neovascular age-related macular degeneration: nAMD is a leading cause of vision loss in older adults and increasingly viewed as part of systemic aging that involves vascular and inflammatory pathways. Using Korean National Health Insurance Service data, a nationwide cohort of 334,091 individuals (83,742 with nAMD and 250,349 matched controls) was followed for up to 10 years. Patients with nAMD showed a modest but statistically significant increase in overall cancer risk (adjusted hazard ratio 1.084; P < 0.001), with selective elevations for pancreatic (aHR 1.155; P < 0.001), lung (aHR 1.128; P < 0.001), thyroid (aHR 1.241; P < 0.001), renal (aHR 1.177; P = 0.002), bladder (aHR 1.121; P = 0.002), and prostate (aHR 1.085; P < 0.001) cancers. No significant associations were observed for many other malignancies. These results suggest that nAMD may act as a clinical marker of systemic vulnerability to selected cancers via shared angiogenic, inflammatory, and polygenic aging-related mechanisms.