Risk for coronary heart disease increases risk for colorectal neoplasm.
OBJECTIVE
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 (≥20%) 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 ≥10% might benefit from colonoscopy screening, but further studies are needed to confirm and generalize these results.
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
Ji Young
JY
Lee
Sung Noh
SN
Hong
Jeong Hwan
JH
Kim
Won Hyeok
WH
Choe
Sun-Young
SY
Lee
In Kyung
IK
Sung
Hyung Seok
HS
Park
Chan Sup
CS
Shim
D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D003327:Coronary Disease / Q000150:complications* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment