The association between lifestyle and cardiovascular disease in colorectal cancer survivors

The aim of this study was to assess how many colorectal cancer (CRC) survivors had a cardiovascular disease (CVD) and to determine the association between lifestyle factors and CVD. In this study overweight CRC survivors were more likely to suffer from CVD.

In the last years the number of CRC survivors has increased as a result to early detection and medical advances regarding cancer therapies. However, CRC survivors have a higher risk of associated disease due to genetic and lifestyle factors. The most common lifestyle risk factors are being overweight/obesity, reduced physical activity, poor diet and smoking. A lifestyle improvement after cancer diagnosis may decrease the course of existing associated diseases or the development of new ones.

This study was conducted between 2003 and 2004 on 1966 CRC survivors. Data was collected at 5, 12, 24 and 36 months post-diagnosis. Patients were evaluated for six CVD: hypercholesterolemia (high blood cholesterol levels), hypertension (high blood pressure), diabetes (high blood sugar levels), heart failure, kidney disease, ischaemic heart disease (reduced blood supply to the heart). The lifestyle factors studied were weight, physical activity, television viewing, alcohol drinking and smoking.

The results showed that at 5 months after cancer diagnosis 59% of the CRC patients had a CVD. Also, 16% of the patients with no known CVD developed a new condition by 36 months. Hypertension was the most common CVD (41% of all patients), followed by hypercholesterolemia and diabetes. Obesity at the moment of diagnosis predicted new onset of hypertension and diabetes. Patients who were watching more than 4 hours of TV daily were more likely to develop a heart condition by 36 months. Alcohol consumption and smoking were not significant risk factors. However the risk was decreased for former smokers and moderate alcohol drinkers.

In conclusion CVD was common following CRC diagnosis and may have a negative impact on survival. Overweight/obese CRC survivors were more likely to suffer from a CVD. It is important to manage and prevent CVD in those at high risk. Focusing on weight management and other lifestyle risk factors may improve survival and the quality of life of CRC survivors.

One of the strengths of the study is the fact that many patients were involved. However, all the data were self-reported through phone interview thus may provide equivocal information.