The intersection of colorectal cancer and cardiovascular disease: shared mechanisms and clinical implications

Colorectal cancer (CRC) and cardiovascular disease (CVD) are major contributors to the global disease burden, with CRC as the third most common malignancy and second leading cause of cancer-related death, and CVD as the top killer among non-communicable diseases. The growing ageing population has driven a continuous rise in CRC-CVD comorbidity. Treatment-related cardiovascular toxicity, shared pathophysiological links, and the prognostic impact of comorbidity have made this interdisciplinary field a critical focus in cardio-oncology. This review addresses core scientific questions at the CRC-CVD intersection, including their shared risk factors and pathological mechanisms (metabolic syndrome, chronic inflammation, oxidative stress, gut microbiota dysbiosis, etc.), epidemiological and molecular associations between CRC and major CVD subtypes, as well as cardiovascular toxicity mechanisms, monitoring, and intervention strategies for CRC therapies (chemotherapy, targeted therapy, immunotherapy). Beneficial lifestyle modifications and cross-effective medications, together with multidisciplinary team (MDT) collaboration, hold great value for comorbidity management. Current studies have confirmed their epidemiological and partial mechanistic links, but key gaps remain: unclear core molecular regulatory networks, insufficient gut microbiota-cardiovascular-tumor axis research, lack of personalized risk prediction models, limited long-term cardiovascular data for novel anticancer drugs, and absent standardized precision prevention protocols. Future multi-omics studies, large-scale clinical trials, and real-world data research will help clarify shared targets, build risk models, and formulate interdisciplinary management guidelines to improve outcomes of CRC-CVD comorbidity patients.