The Association of Cardiovascular Comorbidities with Malignant and Benign Colorectal Neoplasms

Background: Each year, thousands of patients are diagnosed with gastrointestinal (GI) bleeding. Many of these patients undergo colonoscopy and are subsequently diagnosed with benign or malignant colorectal neoplasms. Aim of this study is to evaluate whether patients with cardiovascular comorbidities, many of whom are on anti-platelet or anticoagulation therapy, are more likely to be diagnosed with new benign or malignant colorectal neoplasms than patients without cardiovascular comorbidities. Methods : From the 2007-2011 NIS, 802,080 primary lower GI bleed admissions (ICD-9) were identified; 283,925 had cardiovascular comorbidities. We compared patients with vs without these comorbidities for the primary outcome of new benign or malignant colorectal neoplasms. Weighted analyses accounting for the complex survey design were performed in SAS 9.4, with trends assessed using Cochran-Armitage tests and linear regression and associations with colorectal cancer stage evaluated by multinomial logistic regression (p [≤] 0.05). Results: Between 2007-2011, the odds of malignant colorectal neoplasms increased between 49.9% and 65.3% for patients without cardiovascular comorbidities when presenting with a lower GI bleed, compared to those with cardiovascular comorbidities. Between 2007 and 2011, the most notable and statistically significant difference was observed in 2010, when patients with cardiovascular comorbidities had 10.5% higher odds of being diagnosed with benign colorectal neoplasms than those without cardiovascular comorbidities. Conclusion: Patients presenting with a lower gastrointestinal bleed without cardiovascular comorbidities were significantly more likely to be diagnosed with malignant colorectal neoplasms than those with cardiovascular comorbidities.