Gastrointestinal malignancies and cardiovascular diseases--Non-negligible comorbidity in an era of multi-antithrombotic drug use.

Nowadays, antiplatelet and anticoagulant drug medications are indicated in patients with a variety of cardiovascular disorders, such as atrial fibrillation, coronary artery disease, and peripheral artery disease. Among cardiology patients, regardless of gastrointestinal (Gl) protection, we do not infrequently encounter those patients who have signs and symptoms that are suggestive of Gl tract problems. We should bear in mind that such Gl signs and symp-toms may be attributed to Gl cancers, as well as to benign or clinically insignificant lesions. Several clinical studies have shown, albeit controversially that the predictive value of posi-tive fecal occult blood for colorectal malignant neoplasm may not be lower in patients taking antithrombotic medication. In addition, it has been shown that in patients taking antithrom-botic drug(s), diagnosed colorectal malignancies are in a relatively earlier phase, suggesting that antithrombotic drugs may facilitate the detection of otherwise unrecognized cancers. The possibility also exists that certain cardiovascular disease may be associated with a higher risk of Gl malignant neoplasms. There has been no established evidence concerning whether more aggressive Gl tract screening will reduce the probability of cancer death in cardiology patients; nevertheless, Gl tract lesions should not be overlooked among cardiology patients, especially when unexplained anemia, gastrointestinal symptoms, or positive fecal occult blood test is present, and Gl tract screening should be performed with appropriate timing. © 2011 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. [ABSTRACT FROM AUTHOR]