Kanishk AGGARWAL, Abdullah SAFDAR, Maria TAHIR, FNU ANAMIKA, Shubhangi SINGH, Sai Gautham KANAGALA, Guntash KAUR, Smriti KOCHHAR, Baltej SINGH, Rohit JAIN
Turkish Journal of Internal Medicine - 2026;8(1):105-120
Objective: To examine the association between colorectal cancer (CRC) and cardiovascular disease (CVD), evaluating shared risk factors, treatment-related cardiac complications, and the need for multidisciplinary care approaches. Methods: This narrative review was based on a structured literature search of PubMed/MEDLINE, Embase, Scopus, and Google Scholar for articles published from database through March 2025. The search combined the keywords "colorectal cancer," "colon cancer," "cardiovascular disease," "cardiotoxicity," "atherosclerosis," "gut dysbiosis," "NF- kappaB," "obesity," and "cardio-oncology" using the Boolean operators "AND" and "OR." Original studies, systematic reviews, meta-analyses, and relevant narrative reviews addressing shared risk factors, pathophysiological mechanisms, or treatment-related cardiac effects linking colorectal cancer and cardiovascular disease were eligible for inclusion. Titles and abstracts were screened for relevance, and the full texts of potentially eligible articles were then assessed against these criteria. Articles were excluded if they were not available in English, were conference abstracts without an accompanying full text, or did not directly address the colorectal cancer-cardiovascular disease relationship. The reference lists of retrieved articles were hand-searched to identify additional relevant studies. Given the narrative design of this review, a formal quality appraisal and quantitative (meta-analytic) synthesis were not undertaken. Results: Patients with colorectal cancer demonstrated significantly elevated cardiovascular disease risk compared to non-cancer populations, with prevalence increasing over recent decades. Key contributing factors included aging demographics, shared lifestyle risk factors (obesity, hypertension, insulin resistance), and overlapping pathophysiological mechanisms between both conditions. Chemotherapy-induced cardiotoxicity emerged as a major clinical challenge, frequently necessitating treatment modifications or interruptions. The presence of concurrent cardiac conditions complicated cancer treatment protocols, requiring careful balance between oncological efficacy and cardiovascular safety. Treatment delays due to cardiac complications were associated with suboptimal cancer outcomes. Conclusion: The bidirectional relationship between colorectal cancer and cardiovascular disease necessitates integrated care approaches. The rising prevalence of CVD in CRC patients, combined with treatment-related cardiac complications, underscores the critical need for multidisciplinary teams incorporating both cardiology and oncology expertise. Early cardiovascular risk assessment, proactive cardiac monitoring during cancer treatment, and collaborative care protocols are essential for optimizing patient outcomes. This cardio-oncology approach ensures comprehensive management of both conditions while minimizing treatment interruptions and maximizing therapeutic efficacy for improved patient survival and quality of life.
