Some of the same risk factors for coronary artery disease also increase risk for colon polyps and colorectal cancer. In an effort to find out if there was an association between coronary artery disease and pre-malignant colorectal polyps and cancers, patients who had an angiography for suspected coronary artery disease also had a screening colonoscopy.
Three groups in Hong Kong were identified for the study: coronary artery disease (CAD) positive, CAD negative, and a sex and age matched control group recruited from the general population. Patients were considered to be CAD positive if their angiography showed at least a 50 percent narrowing in any one of the major coronary arteries.
Patients who used aspirin or statins, had a personal history of colorectal disease, or who had a colonoscopy in the past ten years were not included in the analysis.
After adjusting for age and sex, CAD positive patients were almost twice as likely to have a polyp or cancer than those without coronary artery disease. They were two and a half times as likely to have cancer.
Any colorectal neoplasm found::
- CAD positive: 34 percent
- CAD negative: 18.8 percent
- General population: 20.8 percent
Advanced colorectal adenoma (polyp) found:
- CAD positive: 18.4 percent
- CAD negative 8.7 percent
- General population: 5.8 percent
Colorectal cancer:
- CAD positive: 4.4 percent
- CAD negative: 0.5 percent
- General population 1.1 percent
Patients who smoked had five times the risk of having both coronary artery disease and an advanced colorectal polyp or cancer. Those with metabolic syndrome had six times the associated risk.
Annie On On Chan, MD, PhD and her colleagues concluded,
In this study population undergoing coronary angiography, the prevalence of colorectal neoplasm was greater in patients with CAD. The association between the presence of advanced colonic lesions and CAD was stronger in persons with the metabolic syndrome and a history of smoking.
SOURCE: Chan et al, Journal of the American Medical Association, Volume 298, Number 12, September 26, 2007.
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