Systemic cancer risk profile in neovascular age-related macular degeneration: insights into shared aging-related mechanisms from a nationwide population-based study

Neovascular age-related macular degeneration (nAMD) is a leading cause of vision loss in older adults and is increasingly recognized as a manifestation of systemic aging involving vascular and inflammatory pathways. Emerging evidence suggests that nAMD may also be linked to systemic diseases, including malignancies. Using data from the Korean National Health Insurance Service, we conducted a nationwide, population-based cohort study of 334,091 individuals (83,742 with nAMD and 250,349 matched controls) followed for up to 10 years. Patients with nAMD showed a modest but significant increase in overall cancer risk (adjusted hazard ratio [aHR], 1.084; P < 0.001), with selectively elevated risks 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 other malignancies. These findings indicate that nAMD may serve as a clinical marker of systemic vulnerability to selected cancers, possibly through shared angiogenic, inflammatory, and polygenic mechanisms underlying aging-related disease susceptibility.