Retrospective Cohort Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2025; 17(3): 101260
Published online Mar 15, 2025. doi: 10.4251/wjgo.v17.i3.101260
Increased risk of colorectal cancer in young males with higher cardiovascular risk: A nationwide population-based cohort study
Ji Hyun Song, Su-Yeon Choi, Young Sun Kim, Sun Young Yang, Kyung-Do Han
Ji Hyun Song, Young Sun Kim, Sun Young Yang, Internal Medicine and Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul 06236, South Korea
Su-Yeon Choi, Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 06236, South Korea
Kyung-Do Han, Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, South Korea
Co-corresponding authors: Young Sun Kim and Kyung-Do Han.
Author contributions: Song JH contributed to conceptualization, methodology, writing original draft; Choi SY contributed to conceptualization, writing review and editing; Kim YS contributed to conceptualization, formal analysis, methodology, writing, review and editing; Yang SY contributed to conceptualization, supervision, writing, review and editing; Han KD contributed to formal analysis, methodology, data curation, software, supervision; All authors contributed to manuscript revision, read, and approved the submitted version.
Institutional review board statement: The study protocol was approved by the ethics committee of Soongsil University (IRB No. SSU-202007-HR-236-01) and was conducted in accordance with the Declaration of Helsinki.
Informed consent statement: Patient consent was waived, given the retrospective nature of this study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Young Sun Kim, MD, PhD, Professor, Internal Medicine and Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, 39th FL. GFC, Yeoksam dong Gangnam gu, Seoul 06236, South Korea. yspanda@gmail.com
Received: September 9, 2024
Revised: December 12, 2024
Accepted: January 9, 2025
Published online: March 15, 2025
Processing time: 158 Days and 3.6 Hours
Abstract
BACKGROUND

Although the link between cardiovascular disease (CVD) and various cancers is well-established, the relationship between CVD risk and colorectal cancer (CRC) remains underexplored.

AIM

To elucidate the relationship between CVD risk scores and CRC incidence.

METHODS

In this population-based cohort study, participants from the 2009 National Health Checkup were followed-up until 2020. The cardiovascular (CV) risk score was calculated as the sum of risk factors (age, family history of coronary artery disease, hypertension, smoking status, and high-density lipoprotein levels) with high-density lipoprotein (≥ 60 mg/dL) reducing the risk score by one. The primary outcome was incidence of newly diagnosed CRC.

RESULTS

Among 2526628 individuals, 30329 developed CRC during a mean follow-up of 10.1 years. Categorized by CV risk scores (0, 1, 2, and ≥ 3). CRC risk increased with higher CV risk scores after adjusting for covariates [(hazard ratio = 1.155, 95% confidence interval: 1.107-1.205) in risk score ≥ 3, P < 0.001]. This association was exclusively observed in males, most notably in the younger cohort (< 50 years) and was more pronounced in individuals not using statins. Moreover, even in participants without diabetes, a higher CV risk was associated with an increased CRC risk.

CONCLUSION

Increased CV risk scores were significantly associated with higher CRC risk, especially among males, younger populations, and non-statin users. Thus, males with a higher CV risk score, even at a younger age, are recommended to control their risk factors and undergo individualized CRC screening.

Keywords: Colorectal cancer; Cardiovascular disease; Cohort study; Age; Gender

Core Tip: While studies have reported an association between cardiovascular disease (CVD) and colorectal cancer (CRC), large-scale investigations on the incidence of CRC based on the risk of CVD are lacking. This study benefits from being a nationwide population-based cohort study with long-term follow-up data spanning 10 years, which is a significant strength. This study highlights that increased cardiovascular risk scores are significantly associated with higher CRC risk, especially among males and younger populations. Thus, males with a higher cardiovascular risk score, even at a younger age, are recommended to control their risk factors and undergo individualized CRC screening.