A new study has shed light on a critical but often overlooked consequence of colorectal cancer: the elevated risk of heart-related death. While much attention is placed on the direct impact of cancer itself, researchers are emphasizing the need to also monitor cardiovascular health—particularly in the early years following a diagnosis.
Key Findings from the Study:
- Individuals diagnosed with colorectal cancer face a significantly higher risk of dying from heart-related conditions, a risk likely influenced by both the disease and the side effects of cancer treatments.
- This heightened risk is most pronounced during the first two years following diagnosis, especially among adults under the age of 50.
- Experts suggest that patients can lower their risk by adopting healthier lifestyle choices, such as improving diet and exercise habits, and by effectively managing existing conditions like hypertension and diabetes.
The findings underscore the importance of a comprehensive approach to cancer care—one that considers not just the disease itself, but also the broader impact on cardiovascular health.
New Findings
A recent large-scale study has revealed a sobering reality for individuals diagnosed with colorectal cancer: the fight for survival doesn’t end with the cancer itself. Cardiovascular disease is emerging as a significant risk factor, particularly in the early years following diagnosis. According to new research presented at the American College of Cardiology’s Annual Scientific Session in Chicago, patients with colorectal cancer are 16% more likely to die from cardiovascular complications than individuals without the disease. This insight adds a new layer of urgency to the way cancer care is approached, with growing calls for more comprehensive attention to heart health during and after treatment.
A Landmark Population-Based Study
This study analyzed medical records from over 630,000 patients diagnosed with colorectal cancer between 2000 and 2021. According to lead author Ahsan Ayaz, MD, an internal medicine resident at Montefiore St. Luke’s Cornwall Hospital in Newburgh, New York, the scale of the data enabled researchers to pinpoint specific risk patterns across subgroups. “To our knowledge, this is the first population-based study assessing disparity in cardiovascular mortality in different groups among patients diagnosed with colorectal cancer,” Dr. Ayaz stated.
By examining data across a 21-year span, the study explored not just the general risk but also identified the periods and populations most vulnerable to heart-related fatalities. These insights, experts say, could pave the way for more targeted interventions to improve both cancer and cardiovascular outcomes.
The First Two Years: A Window of Vulnerability
Among the study’s most notable findings is that the first two years following a colorectal cancer diagnosis are the most dangerous in terms of cardiovascular risk. During this time, the likelihood of dying from heart-related conditions increases by a staggering 45%.
Although the study didn’t delve into the biological mechanisms behind this trend, medical professionals suspect that the intensive treatment regimens typically undertaken during this period may be partially to blame. Chemotherapy, radiation, and surgery—mainstays of colorectal cancer therapy—can each have negative effects on the cardiovascular system.
“Previous studies have also shown an initial spike in risk within the first year, with another increase beyond five years, likely reflecting long-term effects of treatment and survivorship-related factors,” noted Robert S. Copeland-Halperin, MD, an assistant professor of cardiology at the Zucker School of Medicine at Northwell Health and a member of the cardio-oncology council of the American College of Cardiology. Though not involved in the research, Copeland-Halperin emphasized the need for long-term monitoring of heart health in cancer survivors.
Who’s Most at Risk?
The findings revealed several vulnerable groups, with younger adults standing out in particular. Those under the age of 50 with colorectal cancer were found to be 2.4 times more likely to die from cardiovascular causes than their peers without the disease.
“This is one of the most curious aspects of the study,” Ayaz said. Although the exact cause remains unclear, he highlighted the rising incidence of colorectal cancer in younger adults as an area of growing concern. Some experts believe that the aggressive nature of early-onset colorectal cancer, and the correspondingly intense treatments required, may significantly impact heart health.
Salim Hayek, MD, a cardiologist at the University of Texas Medical Branch and chair of the American Heart Association’s cardio-oncology committee, speculates that there could be a genetic link as well. “Possible genetic factors may also link early-onset colorectal cancer with cardiovascular vulnerability,” he said. Additionally, Hayek explained that commonly used treatments such as 5-fluorouracil can directly harm the cardiovascular system, causing vasospasms, ischemia, arrhythmias, and secondary effects like high blood pressure and arterial plaque buildup.
Racial and Gender Disparities Highlighted
The study also uncovered stark disparities among different demographic groups. Black patients with colorectal cancer had a 74% higher risk of dying from heart-related conditions compared to Black individuals without cancer. This aligns with longstanding data from the American Heart Association, which indicates that Black Americans face disproportionately high rates of hypertension, heart disease, and stroke.
Men, too, appeared more vulnerable than women in this study, with male colorectal cancer patients showing a 55% greater risk of cardiovascular death. While the reasons may be multifaceted, this finding is consistent with broader cardiovascular statistics showing men generally at higher risk for heart disease.
Proactive Steps to Protect the Heart
Given these findings, experts are urging patients and clinicians to take a more integrated approach to cancer treatment—one that doesn’t neglect cardiovascular health. Helga Van Herle, MD, a cardiologist with Keck Medicine of USC, stresses the importance of proactive management. “Ask questions of your treating doctors about your personal risk factors for developing heart disease, especially when facing a cancer diagnosis, and ask about cardiovascular risks associated with the proposed treatment for your cancer,” she advised.
To mitigate heart-related risks, Van Herle and others recommend the following steps:
- Manage blood pressure and cholesterol levels
- Control blood sugar if diabetic
- Quit smoking
- Adopt a healthy diet and maintain a healthy weight
- Engage in regular physical activity
Dr. Copeland-Halperin echoed these sentiments, adding, “While patients diagnosed with cancer can’t change the past, we know that potentially treatable risk factors—including lifestyle choices and conditions like high blood pressure, diabetes, and elevated cholesterol—increase the risk for heart-related complications. So addressing these represents a significant potential opportunity to improve outcomes.”
A New Paradigm in Cancer Care
As survival rates improve for many cancers, including colorectal cancer, attention is increasingly turning to the long-term health of survivors. This study highlights the need for oncologists, cardiologists, and primary care providers to work more collaboratively in managing not only the malignancy but also the cardiovascular risks that come with it.
Cancer survivors often leave behind the frequent check-ins of active treatment, but the cardiovascular risks do not disappear. Instead, as this research shows, those risks may just be beginning—especially in the critical two years after diagnosis. As awareness of this link grows, the hope is that integrated care models will become standard practice, allowing patients to thrive not just as survivors of cancer, but as survivors in every sense of the word.
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