Young people with colon cancer are ‘significantly’ more likely to die from heart problems than the general population, experts warn.
Researchers found people with colorectal cancer were 16 percent more likely to die from cardiovascular disease (CVD) – a group of heart conditions like heart attack and high blood pressure – than those without colon cancer.
In patients diagnosed with colon cancer within the last two years, their risk more than doubled.
However, the link was most devastating in young patients, who are increasingly being ravaged by colon cancer.
Colon cancer patients under the age of 50 were nearly 2.5 times more likely to die from cardiovascular disease than their peers.
While the researchers do not know why there is a link between colon cancer and mortality from CVD, they suggested aggressive cancer treatments like chemotherapy and radiation could damage the heart, leading to an increased risk of conditions like heart attack.
Younger people are also more likely to need more intense cancer treatments, as they are at a higher risk of being diagnosed at later stages due to a lack of screening and attributing symptoms to more benign causes.
Based on their findings, researchers called for increased research and surveillance on cardiovascular outcomes in young patients with colon cancer, especially within the first two years after diagnosis.
Rates of colorectal cancer in Americans under 50 have risen over the past two decades. This graph shows the latest year for which data is available
Data shows that heart attack cases are on the rise in young people
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Dr Ahsan Ayaz, study author and an internal medicine resident at Montefiore St Luke’s Cornwall Hospital in New York, said: ‘Based on our findings, the two-year period after a colorectal cancer diagnosis is a critical period when patients need aggressive care to improve cardiovascular outcomes.
‘For example, there should be an aggressive approach to control cardiovascular risk factors and comorbidities like diabetes and hypertension.
‘There is also a need for coordination between oncology teams and primary care teams, because most of those risk factors are managed by primary care providers.’
Colorectal cancer is the fourth most common cancer in the US and the second-leading cause of cancer deaths.
The American Cancer Society estimates 154,270 Americans will be diagnosed with colon cancer this year, and 52,900 will die.
In the UK, 44,063 cases are diagnosed per year, and the nation experiences 16,808 deaths every year.
And since the 1990s, early-onset colon cancer has increased by 50 percent, and rates are expected to double between 2010 and 2030.
The new study, which will be presented later this month at the American College of Cardiology’s Annual Scientific Session, looked at data from 630,000 patients in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database.
While some warning signs are easy to spot — such as severe chest pain — others are more vague and hard to pinpoint
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All patients were diagnosed with colorectal cancer between 2000 and 2021. The patients’ exact ages are unknown.
Cardiovascular mortality was defined as deaths from heart disease, high blood pressure, stroke, tears or aneurysms in the aorta, or atherosclerosis – a buildup of plaque in the arteries.
The researchers found colorectal cancer patients overall had a 16 percent increased risk of dying from cardiovascular causes.
It’s unclear what demographic they used as a control group.
Their likelihood of dying from these conditions was highest in the first two years after their colorectal cancer diagnosis, increasing to 45 percent during this period.
Colon cancer patients under age 50 were 2.4 times more likely to die of cardiovascular issues than people in the same age group who did not have cancer.
Additionally, researchers concluded that Black colorectal cancer patients had a 74 percent increased chance of dying from cardiovascular issues, and white men were at a 55 percent increased risk.
Dr Ayaz suggested the racial disparities could be due to socioeconomic issues, location, and access to care, but added that more research on this is needed.
The researchers said the increased risk among colon cancer patients could stem from heart damage linked to cancer treatments like chemotherapy and radiation, called cardiotoxicity.
Bailey Hutchins of Tennessee, pictured at left, died of colon cancer earlier this year at age 26. Monica Ackermann of Australia, pictured at right, was just 31 when she was diagnosed with colon cancer
These treatments may lead to inflammation, scarring, and other forms of heart damage that makes it more difficult for the heart to function properly.
Colon cancer also results in widespread inflammation that can spread to the heart, making it more prone to damage.
Additionally, the risk of cardiovascular death may be greater in younger people because they need more aggressive treatment, which could increase their chance of cardiotoxicity.
A separate study published earlier this year looking at 25,000 adults with colorectal cancer in Denmark found patients under 50 were more likely to be diagnosed at later stages, meaning their cancer was more prone to spreading.
Later-stage cancer often requires more aggressive combinations of surgery, chemo, radiation, and immunotherapy, all of which can contribute to cardiotoxicity.
Dr Ayaz said: ‘For therapies that are newer, there is not a lot of data on the side effects and toxicities, but evidence is emerging that they cause cardiovascular toxicity.’
The team is planning to conduct additional research on cardiovascular mortality in colon cancer patients receiving different types of treatment.
