Patients with coronary artery disease had high prevalanece of colorectal cancer and adenoma: END-results of metabolic syndrome and smoking

Abstract

Background: Our previous study showed an association between colorectal neoplasm (CN) and coronary artery disease (CAD), probably due to sharing of common risk factors. Aim: To investigate the prevalence of CN in patients with and without CAD in those aged ≥50 years prospectively and to identify the underlying risk factors. Methods: Patients were recruited for screening colonoscopy after undergoing coronary angiography. They were defined as CAD+ (n=206) if ≥50% diameter stenosis was observed in any one of the major coronary arteries, and CAD- (n=208) if not. A second age and sex matched control group was recruited from the general population (n=207). The prevalence of colonic lesions and underlying risk factors was compared by Pearson chi-square test. A bivariate logistic regression analysis was performed to adjust for age and sex and to identify independent risk factors. Results: The prevalence of the lesions in the CAD+, CAD- and general population group were 40.3%, 28.8%, and 32.9% (p=0.045) for endoscopic polyp, 34.0%, 18.8%, and 20.8% (p<0.0001) for CN, 18.4%, 8.7%, and 5.8% (p<0.00001) for advanced lesion, and 4.4%, 0.5%, and 1.4% (p=0.014) for cancer, respectively. All except one cancers were detected at early stage. After adjusting for age and sex, smoking history (OR: 4.74, CI: 1.38 to 19) and metabolic syndrome (OR: 5.99; CI: 1.43 to 28.0) were independent factors for the coexistence of CAD and advanced lesion. Conclusion: Life style modification is important to prevent the development of both CAD and advanced colonic lesions simultaneously. CAD+ is a surrogate marker for high prevalence of CN, necessitating immediate colonoscopy screening.