Key result
CHF in colorectal cancer survivors linked to ~93% higher overall mortality risk.
Why the study?
CHF is a critical comorbidity affecting survival and treatment decisions in CRC patients, but its impact on mortality among CRC survivors needed investigation.
Does a history of congestive heart failure increase overall mortality in long-term colorectal cancer survivors?
Cohort (n=2,675)
Does a history of congestive heart failure increase overall mortality in long-term colorectal cancer survivors?
Hazard Ratio: 1.93 (95% CI 1.54–2.41)
Absolute Event Rate: 36.64% vs 15.23%
p-value: p=<0.001
Congestive heart failure significantly increases the risk of all-cause mortality in long-term colorectal cancer survivors, highlighting the need for integrated cardiovascular and oncological care.
May support integrated cardio-oncology surveillance in colorectal cancer survivors; extends observational comorbidity data but leaves causal inference open.
Background The rising incidence of colorectal cancer (CRC) and cardiovascular diseases, driven by aging populations and lifestyle changes, highlights congestive heart failure (CHF) as a critical comorbidity that significantly affects survival and treatment decisions in CRC patients. CHF not only affects survival outcomes but also complicates clinical decision-making. This study aims to investigate the impact of CHF on mortality among CRC survivors and explore potential factors of mortality. Methods This cohort study analyzed data from the Taiwan Cancer Registry and National Health Insurance Research Database. CRC patients aged 20 years or older (ICD-10-CM: C18–C20) who survived at least five years after diagnosis were included. After a 1:4 exact matching based on age, sex, and clinical stage, Cox regression was used to estimate mortality risk between CRC survivors with and without CHF. Results A total of 535 CRC survivors with CHF and 2140 without CHF were enrolled in this study after matching. CRC survivors with CHF had a significantly higher overall mortality rate than those without CHF (36.64% vs. 15.23%, p < 0.001). After adjusting for potential confounders, CRC survivors with CHF had 1.93-folds risk of mortality (95% CI: 1.54–2.41, p < 0.001) compared to those without CHF. Subgroup analyses by sex, age, clinical stage, Charlson Comorbidity Index (CCI), and treatment types also show that CRC survivors with CHF had significantly higher mortality risk than those without CHF. The top three highest mortality risk ratios were observed in subgroups with a CCI score of 0 (AHR: 2.63, 95% CI: 1.08–6.39), age < 65 years (AHR: 1.87, 95% CI: 1.23–5.57), and advanced clinical stage (AHR: 2.03, 95% CI: 1.51–2.72). Conclusion CRC survivors with CHF demonstrated significantly higher overall mortality compared to those without CHF. This finding presented the prognostic impact of CHF in CRC survivors, so integrated care and early cardiovascular monitoring are essential to improve long-term outcomes.
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Koseki et al. (2026) conducted a cohort in Colorectal cancer survivors (n=2,675). Congestive heart failure vs. Without congestive heart failure was evaluated on Overall mortality (HR 1.93, 95% CI 1.54-2.41, p=<0.001). Congestive heart failure in colorectal cancer survivors was associated with a 1.93-fold increased risk of overall mortality compared to survivors without congestive heart failure.
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