Colorectal Cancer in Young Adults Linked to Higher Risk of Heart-Related Death
Experts caution that younger individuals diagnosed with colorectal cancer face a significantly elevated risk of death from heart-related complications compared to the broader population.
Increased Cardiovascular Disease Risk
Research indicates that individuals with colorectal cancer are 16 percent more likely to die from cardiovascular disease (CVD)—encompassing conditions like heart attack and hypertension—compared to those without the cancer.
For patients diagnosed with colorectal cancer within the preceding two years, this risk more than doubles.
Elevated Risk for Younger Patients
The connection between colorectal cancer and cardiovascular mortality is particularly pronounced in younger patients, a demographic increasingly affected by this cancer.
Colorectal cancer patients under 50 years of age are nearly 2.5 times more likely to succumb to cardiovascular disease compared to their peers without cancer.
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Potential Causes for the Link
While the precise reasons for the correlation between colorectal cancer and CVD mortality remain unclear, researchers propose that aggressive cancer treatments, such as chemotherapy and radiation, may potentially damage the heart. This could elevate the risk of cardiac conditions like heart attacks.
Younger individuals may also be more likely to require intensive cancer treatments due to a higher probability of diagnosis at advanced stages. This late diagnosis is often attributed to lack of routine screening and the misinterpretation of symptoms as benign issues.
Call for Enhanced Monitoring and Research
Based on these findings, researchers advocate for intensified research and monitoring of cardiovascular outcomes in younger colorectal cancer patients, particularly in the initial two years following diagnosis.
Rates of colorectal cancer in Americans under 50 have risen over the past two decades. This graph shows the latest year for which data is available
Data shows that heart attack cases are on the rise in young people
Expert Perspective
Dr. Ahsan Ayaz, the study’s lead author and an internal medicine resident at Montefiore St Luke’s Cornwall Hospital in New York, emphasized the critical nature of the two-year period following a colorectal cancer diagnosis. He stated that patients require proactive care during this time to improve cardiovascular outcomes.
He further suggested the necessity for a comprehensive strategy to manage cardiovascular risk factors and co-existing conditions such as diabetes and hypertension.
Dr. Ayaz also highlighted the importance of collaboration between oncology and primary care teams, as primary care physicians typically manage the majority of these risk factors.
Colorectal Cancer Statistics
Colorectal cancer ranks as the fourth most prevalent cancer in the US and the second leading cause of cancer-related fatalities.
The American Cancer Society estimates approximately 154,270 new diagnoses of colorectal cancer in the US this year, with 52,900 deaths projected.
In the UK, there are around 44,063 new cases diagnosed annually, resulting in 16,808 deaths each year.
Rising Rates of Early-Onset Colorectal Cancer
Since the 1990s, the incidence of early-onset colorectal cancer has surged by 50 percent, and projections indicate a doubling of rates between 2010 and 2030.
Study Methodology
The recent study, slated for presentation at the American College of Cardiology’s Annual Scientific Session, analyzed data from 630,000 patients within the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database.
While some warning signs are easy to spot — such as severe chest pain — others are more vague and hard to pinpoint
All participants received a colorectal cancer diagnosis between 2000 and 2021, with exact ages unspecified.
Cardiovascular mortality was defined as deaths stemming from heart disease, hypertension, stroke, aortic tears or aneurysms, or atherosclerosis (plaque buildup in arteries).
Key Study Findings
The research revealed that, overall, colorectal cancer patients exhibited a 16 percent increased risk of death from cardiovascular causes.
The study did not specify the demographic used as a control group.
The likelihood of cardiovascular death was highest within the initial two years post-diagnosis, escalating to 45 percent during this period.
Colorectal cancer patients under 50 were 2.4 times more susceptible to death from cardiovascular issues compared to cancer-free individuals in the same age bracket.
Racial and Gender Disparities
Additionally, the study concluded that Black colorectal cancer patients faced a 74 percent higher risk of cardiovascular death, while white men were at a 55 percent increased risk.
Dr. Ayaz posited that racial disparities might be linked to socioeconomic factors, geographic location, and healthcare access, but emphasized the need for further investigation.
Treatment-Related Heart Damage
Researchers suggested that the heightened risk among colorectal cancer patients could originate from heart damage, termed cardiotoxicity, associated with cancer treatments like chemotherapy and radiation.
Bailey Hutchins of Tennessee, pictured at left, died of colon cancer earlier this year at age 26. Monica Ackermann of Australia, pictured at right, was just 31 when she was diagnosed with colon cancer
These treatments can trigger inflammation, scarring, and other forms of cardiac damage, impairing heart function.
Colorectal cancer itself can also induce widespread inflammation, potentially affecting the heart and increasing its vulnerability to damage.
Furthermore, the elevated risk of cardiovascular death in younger individuals could be due to their requirement for more aggressive treatment, potentially increasing cardiotoxicity.
Late-Stage Diagnosis in Younger Patients
A separate study from Denmark indicated that colorectal cancer patients under 50 are more prone to diagnosis at later stages, implying a higher likelihood of cancer spread.
Advanced-stage cancer often necessitates more intensive combinations of surgery, chemotherapy, radiation, and immunotherapy, all of which can contribute to cardiotoxicity.
Dr. Ayaz noted the limited data on long-term side effects and toxicities of newer therapies but acknowledged emerging evidence suggesting cardiovascular toxicity as a potential concern.
Future Research Directions
The research team intends to conduct further studies on cardiovascular mortality in colorectal cancer patients undergoing various treatment modalities.