TY - JOUR
T1 - Prevalence of colorectal neoplasm among patients with newly diagnosed coronary artery disease
AU - Chan, Annie On On
AU - Man, Hong Jim
AU - Kwok, Fai Lam
AU - Morris, Jeffrey S.
AU - Siu, David Chun Wah
AU - Tong, Teresa
AU - Fook, Hong Ng
AU - Siu, Yin Wong
AU - Wai, Mo Hui
AU - Chi, Kuen Chan
AU - Kam, Chuen Lai
AU - Ting, Kin Cheung
AU - Chan, Pierre
AU - Wong, Grace
AU - Man, Fung Yuen
AU - Yuk, Kong Lau
AU - Lee, Stephen
AU - Ming, Leung Szeto
AU - Wong, Benjamin C.Y.
AU - Shiu, Kum Lam
PY - 2007/9/26
Y1 - 2007/9/26
N2 - Context: Colorectal neoplasm and coronary artery disease (CAD) share similar risk factors, and their co-occurrence may be associated. Objectives: To investigate the prevalence of colorectal neoplasm in patients with CAD in a cross-sectional study and to identify the predisposing factors for the association of the 2 diseases. Design, Setting, and Participants: Patients in Hong Kong, China, were recruited for screening colonoscopy after undergoing coronary angiography for suspected CAD during November 2004 to June 2006. Presence of CAD (n=206) was defined as at least 50% diameter stenosis in any 1 of the major coronary arteries; otherwise, patients were considered CAD-negative (n=208). An age- and sex-matched control group was recruited from the general population (n=207). Patients were excluded for use of aspirin or statins, personal history of colonic disease, or colonoscopy in the past 10 years. Main Outcome Measures: The prevalence of colorectal neoplasm in CAD-positive, CAD-negative, and general population participants was determined. Bivariate logistic regression was performed to study the association between colorectal neoplasm and CAD and to identify risk factors for the association of the 2 diseases after adjusting for age and sex. Results: The prevalence of colorectal neoplasm in the CAD-positive, CAD-negative, and general population groups was 34.0%, 18.8%, and 20.8% (P<.001 by χ2 test), prevalence of advanced lesions was 18.4%, 8.7%, and 5.8% (P<.001), and prevalence of cancer was 4.4%, 0.5%, and 1.4% (P=.02), respectively. Fifty percent of the cancers in CAD-positive participants were early stage. After adjusting for age and sex, an association still existed between colorectal neoplasm and presence of CAD (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.25-2.70; P=.002) and between advanced lesions and presence of CAD (OR, 2.51; 95% CI, 1.43-4.35; P=.001). The metabolic syndrome (OR, 5.99; 95% CI, 1.43-27.94; P=.02) and history of smoking (OR, 4.74; 95% CI, 1.38-18.92; P=.02) were independent factors for the association of advanced colonic lesions and CAD. Conclusions: In this study population undergoing coronary angiography, the prevalence of colorectal neoplasm was greater in patients with CAD. The association between the presence of advanced colonic lesions and CAD was stronger in persons with the metabolic syndrome and a history of smoking.
AB - Context: Colorectal neoplasm and coronary artery disease (CAD) share similar risk factors, and their co-occurrence may be associated. Objectives: To investigate the prevalence of colorectal neoplasm in patients with CAD in a cross-sectional study and to identify the predisposing factors for the association of the 2 diseases. Design, Setting, and Participants: Patients in Hong Kong, China, were recruited for screening colonoscopy after undergoing coronary angiography for suspected CAD during November 2004 to June 2006. Presence of CAD (n=206) was defined as at least 50% diameter stenosis in any 1 of the major coronary arteries; otherwise, patients were considered CAD-negative (n=208). An age- and sex-matched control group was recruited from the general population (n=207). Patients were excluded for use of aspirin or statins, personal history of colonic disease, or colonoscopy in the past 10 years. Main Outcome Measures: The prevalence of colorectal neoplasm in CAD-positive, CAD-negative, and general population participants was determined. Bivariate logistic regression was performed to study the association between colorectal neoplasm and CAD and to identify risk factors for the association of the 2 diseases after adjusting for age and sex. Results: The prevalence of colorectal neoplasm in the CAD-positive, CAD-negative, and general population groups was 34.0%, 18.8%, and 20.8% (P<.001 by χ2 test), prevalence of advanced lesions was 18.4%, 8.7%, and 5.8% (P<.001), and prevalence of cancer was 4.4%, 0.5%, and 1.4% (P=.02), respectively. Fifty percent of the cancers in CAD-positive participants were early stage. After adjusting for age and sex, an association still existed between colorectal neoplasm and presence of CAD (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.25-2.70; P=.002) and between advanced lesions and presence of CAD (OR, 2.51; 95% CI, 1.43-4.35; P=.001). The metabolic syndrome (OR, 5.99; 95% CI, 1.43-27.94; P=.02) and history of smoking (OR, 4.74; 95% CI, 1.38-18.92; P=.02) were independent factors for the association of advanced colonic lesions and CAD. Conclusions: In this study population undergoing coronary angiography, the prevalence of colorectal neoplasm was greater in patients with CAD. The association between the presence of advanced colonic lesions and CAD was stronger in persons with the metabolic syndrome and a history of smoking.
UR - https://www.scopus.com/pages/publications/34748904899
U2 - 10.1001/jama.298.12.1412
DO - 10.1001/jama.298.12.1412
M3 - Article
C2 - 17895457
AN - SCOPUS:34748904899
SN - 0098-7484
VL - 298
SP - 1412
EP - 1419
JO - JAMA
JF - JAMA
IS - 12
ER -
