Chemotherapy as a protective factor against cardiocerebrovascular disease mortality in colorectal cancer patients based on SEER database

Q: What are the key findings of this study?

Chemotherapy independently reduced the risk of cardiocerebrovascular disease-related mortality by 25% (sHR 0.75) compared to no chemotherapy in colorectal cancer patients aged 50 and older.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Colorectal cancer (n=136095). Intervention: Chemotherapy vs. No chemotherapy. Primary outcome: Cardiocerebrovascular disease (CCVD)-related mortality (sHR 0.75, 95% CI 0.71-0.79, p=<0.001).

Q: What question did this study set out to answer?

To clarify the association between chemotherapy and cardiocerebrovascular disease-related mortality in middle-aged and elderly patients with colorectal cancer.

Yingna Chen; Bin Zhou; Guitao Wu; Yiming Cai; Yaxin Lu; Xinxin Cheng; Xi Zhang; Ling Long

doi:10.1007/s12672-026-05008-x

April 26, 2026Discover OncologyOpen Access

Chemotherapy as a protective factor against cardiocerebrovascular disease mortality in colorectal cancer patients based on SEER database

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Key result

Chemotherapy linked to ~25% lower CCVD mortality vs. no chemotherapy in CRC patients over 50.

sHR 0.75
95% CI 0.71-0.79
P<0.001
n=136,095

Figures

Why the study?

Does systemic chemotherapy reduce cardiocerebrovascular disease-related mortality in middle-aged and elderly patients with colorectal cancer?

Key Points

To clarify the association between chemotherapy and cardiocerebrovascular disease-related mortality in middle-aged and elderly patients with colorectal cancer.
Analyzed 136 095 patients aged ≥ 50 years diagnosed with colorectal cancer between 2010 and 2015 using the SEER database, stratified into chemotherapy (n = 51 875) and non-chemotherapy (n = 84 220) cohorts.
Assessed cardiocerebrovascular disease-related mortality using Kaplan-Meier survival curves and Fine-Gray multivariate competing risks regression models adjusting for age, race, gender, primary tumor site, and tumor stage.
Cardiocerebrovascular mortality occurred in 3.75% (1947/51 875) of chemotherapy patients compared to 9.68% (8153/84 220) of non-chemotherapy patients.
Multivariate competing risks regression demonstrated that chemotherapy was an independent protective factor against cardiocerebrovascular mortality (sHR = 0.75, 95% CI 0.71–0.79, P < 0.001).
Five-year cardiocerebrovascular survival rates were 96.3% in treated males versus 91.9% in untreated males, and 97.6% in treated females versus 92.0% in untreated females.

Study Design

Type

Cohort (n=136,095)

Multicenter

Yes

Structured PICO

Does systemic chemotherapy reduce cardiocerebrovascular disease-related mortality in middle-aged and elderly patients with colorectal cancer?

P

Population

136,095 adults aged ≥50 years with primary malignant colorectal neoplasms diagnosed between 2010 and 2015, identified from the US Surveillance, Epidemiology, and End Results (SEER) database.

I

Intervention

Systemic chemotherapy (including adjuvant, neoadjuvant, or palliative chemotherapy) before, during, or after other colorectal cancer treatments.

C

Comparator

No documented systemic chemotherapy throughout the entire colorectal cancer treatment course (patients may have received surgery, radiotherapy, or supportive care).

O

Outcome

Cardiocerebrovascular disease (CCVD)-related mortality (defined by ICD-10 codes for aortic aneurysm and dissection, atherosclerosis, cerebrovascular disease, heart disease, hypertension without heart disease, and other diseases of arteries, arterioles, and capillaries).hard clinical

Main Result

Effect estimate: sHR 0.75 (95% CI 0.71-0.79)

Absolute Event Rate: 3.75% vs 9.68%

p-value: p=<0.001

Implication

In middle-aged and elderly patients with colorectal cancer, systemic chemotherapy is independently associated with a 25% reduction in cardiocerebrovascular disease-related mortality.

Abstract

The impact of chemotherapy on cardiocerebrovascular disease (CCVD) outcomes in patients with colorectal cancer (CRC) remains insufficiently explored. This research aimed to clarify the association between chemotherapy and CCVD-related mortality in middle-aged and elderly CRC patients. CRC patients aged ≥ 50 years at diagnosis were identified from the Surveillance, Epidemiology, and End Results (SEER) database for the period 2010–2015. The primary outcome was CCVD-related mortality. Survival analyses included Kaplan-Meier (KM) curves to characterize CCVD-related survival patterns and multivariate competing risks regression analysis to evaluate the independent association between chemotherapy and CCVD-related mortality. Subgroup analyses and Fine-Gray competing risks models were additionally performed to enhance the robustness of study findings. A total of 136 095 CRC patients were included. KM analysis showed a significantly lower cumulative risk of CCVD-related mortality in chemotherapy treatment group than in non-chemotherapy treatment group. After adjusting for age, race, gender, primary tumor site, and tumor stage, multivariate competing risks regression analysis confirmed that chemotherapy was an independent protective factor against CCVD-related mortality (sHR = 0.75, 95% CI 0.71–0.79, P < 0.001). Subgroup analyses and Fine-Gray competing risks models further validated the robustness of chemotherapy’s beneficial effect on CCVD outcomes. Chemotherapy may serve as an independent protective factor against CCVD-related mortality in CRC patients. These findings can help alleviate concerns regarding chemotherapy-associated CCVD risk in CRC management and provide novel insights for clinical decision-making and future research.

Discussion

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Cite This Study

Chen et al. (2026) conducted a cohort in Colorectal cancer (n=136,095). Chemotherapy vs. No chemotherapy was evaluated on Cardiocerebrovascular disease (CCVD)-related mortality (sHR 0.75, 95% CI 0.71-0.79, p=<0.001). Chemotherapy independently reduced the risk of cardiocerebrovascular disease-related mortality by 25% (sHR 0.75) compared to no chemotherapy in colorectal cancer patients aged 50 and older.

synapsesocial.com/papers/69f04e5b727298f751e723b3 https://doi.org/10.1007/s12672-026-05008-x

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Chemotherapy as a protective factor against cardiocerebrovascular disease mortality in colorectal cancer patients based on SEER database

Figures

Key Points

Study Design

Structured PICO

Main Result

Implication

Abstract

Discussion

Cite This Study

Chemotherapy as a protective factor against cardiocerebrovascular disease mortality in colorectal cancer patients based on SEER database

Figures

Key Points

Study Design

Structured PICO

Main Result

Implication

Abstract

Discussion

Cite This Study

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