Congestive Heart Failure and Skin Cancer Risk: A Cross-Sectional Analysis

Introduction Congestive heart failure (CHF) is a chronic inflammatory condition that may influence immune surveillance and cancer risk. While CHF has been linked to increased incidence of certain malignancies, its relationship with skin cancer remains underexplored. Given the systemic immune changes in CHF and the immune-mediated aspects of skin cancer pathogenesis, this study aimed to assess whether CHF is associated with increased prevalence of skin cancer in a nationally representative sample of U.S. adults. Methods We analyzed data from the National Health and Nutrition Examination Survey (NHANES) collected between 2021 and 2023. CHF status was determined by self-reported physician diagnosis, and skin cancer was defined based on self-reported history of melanoma or non-melanoma skin cancer. A multivariable logistic regression model was used to assess the association between CHF and skin cancer, adjusting for age, gender, race/ethnicity, marital status, and education level. Results Among 7,791 participants, 343 (4.4%) reported a history of CHF. Skin cancer prevalence did not significantly differ between CHF and non-CHF groups. In adjusted analysis, CHF was not significantly associated with skin cancer (OR = 1.03, 95% CI: 0.64–1.63, p = 0.903). Female gender was associated with lower odds of skin cancer (OR = 0.65, p = 0.002), while college education was associated with higher odds compared to less than a 9th-grade education (OR = 3.33, p = 0.012). No other covariates showed significant associations. Conclusion Despite theoretical concerns regarding inflammation and immune dysfunction in CHF, we found no evidence that CHF is associated with increased skin cancer prevalence. Our findings suggest that systemic changes in CHF may not meaningfully impact skin cancer risk, or that detection patterns in this population may obscure true associations. The study also underscores the influence of demographic and socioeconomic factors on skin cancer reporting. Further research using prospective designs and detailed cancer subtype data is warranted to clarify potential links between CHF and skin cancer.