title: Lifestyle factors associated concurrently and prospectively with co-morbid cardiovascular disease in a population-based cohort of colorectal cancer survivors.
abstract: OBJECTIVE
  To assess self-reported lifetime prevalence of cardiovascular disease (CVD) among colorectal cancer survivors, and examine the cross-sectional and prospective associations of lifestyle factors with co-morbid CVD.
  
  
  METHODS
  Colorectal cancer survivors were recruited (n=1966). Data were collected at approximately 5, 12, 24 and 36 months post-diagnosis. Cross-sectional findings included six CVD categories (hypercholesterolaemia, hypertension, diabetes, heart failure, kidney disease and ischaemic heart disease (IHD)) at 5 months post-diagnosis. Longitudinal outcomes included the probability of developing (de novo) co-morbid CVD by 36 months post-diagnosis. Lifestyle factors included body mass index, physical activity, television (TV) viewing, alcohol consumption and smoking.
  
  
  RESULTS
  Co-morbid CVD prevalence at 5 months post-diagnosis was 59%, and 16% of participants with no known CVD at the baseline reported de novo CVD by 36 months. Obesity at the baseline predicted de novo hypertension (odds ratio [OR]=2.20, 95% confidence intervals [CI]=1.09, 4.45) and de novo diabetes (OR=6.55, 95% CI=2.19, 19.53). Participants watching >4h of TV/d at the baseline (compared with <2h/d) were more likely to develop ischaemic heart disease by 36 months (OR=5.51, 95% CI=1.86, 16.34).
  
  
  CONCLUSIONS
  Overweight colorectal cancer survivors were more likely to suffer from co-morbid CVD. Interventions focusing on weight management and other modifiable lifestyle factors may reduce functional decline and improve survival.
authors.affiliation: Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Queensland, Australia. Anna.Hawkes@gmail.com
authors.forename: Anna L
authors.initials: AL
authors.lastname: Hawkes
authors.forename: Brigid M
authors.initials: BM
authors.lastname: Lynch
authors.forename: Neville
authors.initials: N
authors.lastname: Owen
authors.forename: Joanne F
authors.initials: JF
authors.lastname: Aitken
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000150:complications* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008019:Life Style; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications; D011446:Prospective Studies; D011793:Queensland / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult