Cardiovascular health assessed by Life’s Essential 8 score, genetic risk, colonoscopy status, and risk of colorectal cancer: an analysis of UK Biobank

OBJECTIVE: Colorectal cancer (CRC) and cardiovascular disease (CVD) share common risk factors. This study explores the association between cardiovascular health (CVH), assessed using the Life's Essential 8 (LE8) score, and CRC risk, while examining the modifying roles of genetic predisposition and colonoscopy screening. METHODS: A total of 291 177 UK Biobank participants were included in the analysis. LE8 comprises eight indicators: diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. Cox proportional hazards models were used for analysis. RESULTS: During a median follow-up of 12.97 years, 3791 incident CRC cases were identified. Compared with low LE8 scores, high LE8 scores were associated with a 26% reduced CRC risk (HR: 0.74; 95% CI 0.64 to 0.86). High LE8 was linked to a 27% lower CRC risk in individuals with high genetic risk (HR: 0.73; 95% CI 0.56 to 0.94) and a 35% reduction in those without a history of colonoscopy screening (HR: 0.65; 95% CI 0.54 to 0.78). Joint analysis showed a 78% lower CRC risk in those with high LE8 and low genetic risk (HR: 0.22; 95% CI 0.15 to 0.34). CONCLUSION: Better CVH is associated with a reduced risk of CRC, particularly in individuals with high genetic susceptibility and those without a history of colonoscopy screening.