Prevalence of colorectal neoplasm in Chinese patients with high‐risk coronary artery disease classified by the Asia–Pacific Colorectal Screening score

Objective The aim of this study was to investigate the prevalence of colorectal neoplasms in patients coronary artery disease (CAD) with or without a family history of colorectal cancer (CRC). Methods In this cross-sectional study, individuals with suspected CAD in the absence of cancer-related symptoms underwent coronary angiography for the first time, and were divided into CAD and non-CAD groups. Colonoscopy was performed in individuals at high-risk tier based on their Asia–Pacific colorectal screening (APCS) score. Their waist circumference (WC), height and body weight were measured. Results There were 634 of 1157 individuals at a high risk of developing advanced colorectal neoplasms, 91.0% (577/634) of whom were male smokers. The proportion of CAD patients in the high-risk tier was 81.5% (517/634), while the prevalences of adenomas (32.1% vs 22.2%, P < 0.05) and advanced adenomas (14.7% vs 8.5%, P < 0.05) were significantly higher in the CAD group than in the non-CAD group. After 83 individuals with a family history of CRC were excluded, only the prevalence of adenomas was still significantly higher in the CAD group than in the non-CAD group (25.5% vs 16.0%, P < 0.01). Body mass index (BMI) ≥25 kg/m2 was correlated with the occurrence of adenomas (OR 2.133, 95% CI 1.219–3.730, P = 0.008) in CAD patients. Conclusions Even in the absence of family history of CRC, CAD patients at a high risk of developing advanced colorectal neoplasms classified by the APCS score still showed a remarkably high prevalence of colorectal adenomas. Moreover, the association between the occurrence of adenomas and CAD was stronger in overweight (BMI ≥25 kg/m2) individuals.