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Coronary heart disease risk associated with colorectal neoplasms
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Patients at greater risk for coronary heart disease are more likely to develop overall and advanced colorectal, as well as multiple and large, neoplasms, according to recent results.
In a cross-sectional study, researchers evaluated 3,144 asymptomatic participants (mean age, 50.5 years; 65.8% men) who underwent colonoscopy between January and December 2010 in Seoul, South Korea. Participants were divided according to Framingham/Adult Treatment Panel III risk scores (FRS) for coronary heart disease (CHD) within the coming 10 years. Patients rated below 10% for FRS were considered low risk (n=2,485); between 10% and 20%, intermediate risk (n=541); and 20% or greater, high risk (n=118). No patients had a history of coronary artery disease or any other vascular disorders.
Colorectal neoplasms (CRN) were observed in 950 cases, including 193 with one or more advanced CRNs. Overall, CRN prevalence increased with CHD risk, occurring in 25.6% of the low-risk, 46.6% of the intermediate-risk and 53.4% of the high-risk participants (P<.001). A similar trend was observed for advanced CRN (4.9%, 9.2% and 17.8%, respectively; P<.001).
Multivariate analysis indicated significantly increased risk for CRN overall in patients aged 50 years or older (OR=1.74; 95% CI, 1.47-2.05), male sex (OR=1.74; 95% CI, 1.39-2.18) and intermediate (OR=1.66; 95% CI, 1.34-2.05) or high 10-year CHD risk (OR=2.26; 95% CI, 1.53-3.35). The risk for advanced CRN was significantly associated with advanced age (OR=2.05; 95% CI, 1.48-2.84) and male sex (OR=1.17; 95% CI, 0.75-1.81), plus CHD risk (OR=3.31; 95% CI, 1.94-5.65). Investigators said patients in the high-risk group were at greater risk for developing multiple (OR=2.9; 95% CI, 1.52-5.52) and large CRN (OR=1.91; 95% CI, 1.03-3.54).
“The patients at risk for CHD were found to have an increased risk of overall and advanced CRN, and referral for screening colonoscopy should be considered,” the researchers concluded. “Although it needs to be validated in an independent population before performing screening colonoscopy on the basis of FRS can be recommended in a clinical setting, the implications of conducting screening colonoscopy on patients with a 10-year risk of CHD [of 10% or higher] might be considered.”
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