Colorectal cancer and comorbidities - implications for surgical practice

Colorectal cancer (CRC) is one of the most common malignant diseases worldwide. Its etiology and prognosis are significantly influenced by numerous comorbidities that may affect both the risk of tumor development and the course of the disease, including treatment response. The aim of this review article is to summarize current knowledge regarding the relationship between CRC and selected diseases and comorbid conditions, drawing on evidence from systematic reviews, meta-analyses, and cohort studies. Type 2 diabetes mellitus, inflammatory bowel disease, metabolic syndrome, obesity, hypertension, chronic kidney disease, and chronic obstructive pulmonary disease are associated with an increased risk of CRC development and adversely affect its prognosis. In the case of obstructive sleep apnea, evidence suggests a potential association; however, current data remain inconsistent and do not allow for a definitive conclusion. Tooth agenesis has been linked to AXIN2 gene mutations, which may reflect a familial predisposition to CRC. The pathophysiological mechanisms connecting these comorbidities with CRC include chronic inflammation, insulin resistance, metabolic and immunological dysregulation, hypoxic pathways, and genetic predispositions. Colorectal cancer is thus a multifactorial disease whose risk of developing and prognosis are substantially modified by patient comorbidities. Understanding these relationships is essential for optimizing preventive strategies, screening programs, and individualized treatment approaches in patients with CRC.