Patients diagnosed with colorectal cancer may have a 16% higher risk of cardiovascular mortality compared with the general population, with risk peaking at 45% during the first 2 years following diagnosis, according to research presented at the American College of Cardiology's Annual Scientific Session 2025.

In the study, simultaneously published in the Journal of the American College of Cardiology, investigators analyzed outcomes from more than 630,000 U.S. adult patients diagnosed with colorectal cancer between 2000 and 2021. They identified specific high-risk populations requiring targeted cardiovascular interventions.

"Based on our findings, the 2-year period after a colorectal cancer diagnosis is a critical period when patients need aggressive care to improve cardiovascular outcomes," said study author Ahsan Ayaz, MD, an internal medicine resident at Montefiore St. Luke's Cornwall Hospital in Newburgh, New York, and colleagues. "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," he emphasized.

The elevated cardiovascular risk was particularly pronounced among certain demographic groups:

• Patients younger than 50 years faced 2.4 times higher risk of cardiovascular mortality compared with age-matched controls without colorectal cancer.
• Black patients experienced a 74% increased risk compared with the general population.
• Male patients showed a 55% elevated risk.

The investigators indicated that these disparities "could stem from multiple factors, such as differences in socioeconomic status, geographic location, or access to care, and warrant further study and attention."

They suggested several potential explanations for the increased cardiovascular mortality risk among patients with colorectal cancer, including treatment side effects, inflammatory processes caused by the cancer itself, or combinations of these factors.

"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," Dr. Ayaz said. "It is important to identify these problems promptly and take steps to mitigate them," he underscored.

The investigators utilized data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database, defining cardiovascular mortality as deaths attributed to cardiovascular disease; hypertension; strokes; as well as other cerebrovascular diseases, atherosclerosis, or aortic aneurysms or tears.

Based on their findings, the investigators plan to conduct a systematic review and meta-analysis examining cardiovascular mortality trends among patients receiving different cancer therapies. They also aim to further explore socioeconomic factors, insurance status, and health care access in clinical trials for colorectal cancer.