International Journal of Clinical Oncology

, Volume 24, Issue 5, pp 501–507 | Cite as

Risk factors for cardiovascular mortality in patients with colorectal cancer: a population-based study

  • Apostolos GaitanidisEmail author
  • Michail Spathakis
  • Christos Tsalikidis
  • Michail Alevizakos
  • Alexandra Tsaroucha
  • Michail Pitiakoudis
Original Article



Patients with colorectal cancer are at increased risk of cardiovascular mortality compared to the general population. The purpose of this study is to identify risk factors of cardiovascular mortality in patients with colorectal cancer.


A retrospective review of the Surveillance Epidemiology and End Results (SEER) database was performed between 2010 and 2014. Standardized Mortality Ratios (SMRs) for cardiovascular mortality were calculated by comparing the number of expected deaths in the United States according to the National Center for Health Statistics (ICD-10 codes I00-I99) to the number of observed deaths in the database. Logistic regression was used to identify independent risk factors.


Overall, 164,719 patients were identified (mean age at diagnosis 67 ± 13.9 years, 52.7% males, 47.3% females), of which 4854 (2.9%) died from cardiovascular disease. The majority of cardiovascular deaths occurred during the first year after diagnosis (2658, 54.8%). SMRs for cardiovascular mortality were 11.7 (95% CI 11.3–12) among all patients, 12.1 (95% CI 11.7–12.6) for male patients and 11.1 (95% CI 10.6–11.6) for female patients, with SMRs being higher for younger patients. Older age, male sex, African–American race, elevated CEA and not undergoing curative surgery were independent risk factors of cardiovascular mortality in patients with colorectal cancer.


Patients with colorectal cancer are associated with an increased risk of cardiovascular death, especially during the first year after diagnosis. Older age, male sex, African–American race, elevated CEA and not undergoing curative surgery are independent risk factors of cardiovascular death.


Colorectal cancer Cardiovascular Mortality 



This study was supported by the General Secretariat for Research and Technology (GSRT) (Grant no. 837) and the Hellenic Foundation for Research and Innovation (HFRI).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10147_2018_1382_MOESM1_ESM.docx (16 kb)
Supplementary material 1 (DOCX 16 KB)


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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  1. 1.Second Department of SurgeryUniversity General Hospital of Alexandroupoli, Democritus University of Thrace Medical SchoolAlexandroupoliGreece
  2. 2.Department of MedicineUniversity of Pittsburgh Medical Center, Department of MedicinePittsburghUSA

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