Impact of cardiovascular disease on colorectal cancer morbidity and prognosis

Abstract

Background: Colorectal cancer (CRC) and cardiovascular disease (CVD) are major global health burdens, sharing common risk factors like obesity, smoking, and diabetes. While CRC’s impact on CVD has been studied, the reverse association remains less explored. The study aims to investigate the relationship between CVD and the morbidity and prognosis of CRC. Materials: This study was conducted across 9 databases (PubMed, Embase, Cochrane, Scopus, Web of Science, CINAHL complete, SPORT Discus, PsycINFO and CNKI) from January 1, 2000, to February 27, 2025. The prognosis were diagnosis of colorectal cancer or postoperative prognosis (including death and complications). This study was analyzed by Stata (V. 16.0) software. Results: A total of 23 studies were included: 11 studies (5,462,791 patients) from 6 countries or regions assessed morbidity risk, and 12 studies (307,857 patients) from 9 countries evaluated postoperative prognosis. Cardiovascular disease (CVD) was associated with increased risks for colorectal cancer (CRC) (RR 1.24, 95%CI 1.04 to 1.48) (CI, confidence intervals) (RR, relative risk), postoperative arrhythmia (RR 3.05, 95%CI 1.27 to 7.35), and all-cause mortality (RR 1.56, 95%CI 1.26 to 1.94). Subgroup analysis shows that heart failure (HF) may be a risk factor for CRC (RR 1.39, 95%CI 1.03 to 1.89) and all-cause mortality (RR 1.68, 95%CI 1.49 to 1.90). Among female patients, HF (RR 2.32, 95%CI 1.39 to 3.88) and heart failure with preserved ejection fraction (HFpEF) (RR 2.54, 95%CI 1.52 to 4.24) show associations with CRC. Conclusions: CVD was associated with increased risks of CRC incidence and all-cause mortality in CRC patients, with HF specifically linked to both outcomes. However, no conclusive associations emerged between CVD and postoperative complications beyond arrhythmia. Further investigation into physiological mechanism is required. Prospero id: CRD420251020352.