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Background & Aims
Colorectal neoplasms and coronary artery disease have similar risk factors. Patients with established coronary artery disease have a high prevalence
of colorectal neoplasms. However, little is known about the risk
of colorectal neoplasms among individuals at risk for coronary artery disease.
Methods
We performed a cross-sectional study of 3144 asymptomatic, average-risk individuals without history of coronary artery disease or other vascular disorders who received a screening colonoscopy examination from January to December 2010 at Konkuk University Medical Center in Seoul, Korea. Participants were classified as having low (<10 % ), intermediate (10 % -20 % ), or high (¡Ý20 % ) risk for developing coronary artery disease in the next 10 years, which was based on Framingham/Adult Treatment Panel III risk scores.
Results
The prevalence of colorectal neoplasms in subjects with low, intermediate, and high risk for coronary artery disease was 25.6 % (635/2485), 46.6 % (252/541), and 53.4 % (63/118), respectively (P < .001); the prevalence of advanced colorectal neoplasms was 4.9 % (122/2485), 9.2 % (50/541), and 17.8 % (21/118), respectively, for these subjects (P < .001). In multivariate analyses, the high-risk group had a significantly increased risk of advanced colorectal neoplasm (odds ratio, 3.31; 95 % confidence interval [CI], 1.94-5.65), compared with the low-risk group. The numbers of colonoscopies needed to identify individuals with advanced colorectal neoplasms in intermediate-risk and high-risk groups were 10.8 (95 % CI, 8.6-14.7) and 5.6 (95 % CI, 7.6-11.9), respectively, which were significantly lower than for the low-risk group (20.4; 95 % CI, 17.4-24.6).
Conclusions
The prevalence and the risk of overall and advanced colorectal neoplasms increase with risk of coronary artery disease. Individuals with a 10-year risk of coronary artery disease ¡Ý10 % might benefit from colonoscopy screening, but further studies are needed to confirm and generalize these results.
