Association of Cardiovascular Risk Assessment with Early Colorectal Neoplasia Detection in Asymptomatic Population: A Systematic Review and Meta-Analysis

Abstract

Previous studies have shown a strong coexistence of colorectal neoplasia (CRN) and cardiovascular diseases (CVD). This study was aimed to summarize the available evidence on association of CVD risk with early CRN detection in asymptomatic populations. PubMed, Web of Science, and Embase were systematically searched for eligible studies published until Dec 20, 2019. Studies exploring the associations of recommended CVD risk assessment methods (e.g., risk scores, carotid artery plaque, and coronary artery calcium score [CACS]) with risk of CRN were included. Meta-analyses were conducted to determine the overall association of CVD risk with the CRN. A total of 12 studies were finally included. The association of carotid artery plaque with the risk of colorectal adenoma (AD) was weakest (pooled odds ratio [OR)] 1.27, 95% confidence interval [CI), 1.12, 1.45]. Participants with CACS>100 had about 2-fold increased risk of AD than those with CACS=0. The pooled ORs were 3.36 (95% CI, 2.15, 5.27) and 2.30 (95% CI, 1.69, 3.13) for the risk of advanced colorectal neoplasia (AN) and AD, respectively, in participants with Framingham risk score (FRS)>20%, when compared to participants at low risk (FRS<10%). FRS might help identify subgroups at increased risk for AN, but further studies are needed.

Keywords:

• cardiovascular disease
• risk assessment
• colorectal neoplasia

Abbreviations

ABI, ankle-brachial index; AD, colorectal adenoma; AN, advanced colorectal neoplasia; CACS, coronary artery calcium score; CAP, carotid artery plaque; CHD, coronary heart disease; CI, confidence interval; CRC, colorectal cancer; CRN, colorectal neoplasia; CVD, cardiovascular disease; FRS, Framingham risk score; HR, hazard ratio; HRA, high risk adenoma; MR, medical records; NR, not reported; OR, odds ratio; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; QUADAS-2, Quality Assessment of Diagnostic Accuracy Studies-2; Q, questionnaires; SD, standard deviation.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This research was funded by National Natural Science Foundation of China, grant number 81773684.