Untreated Hypertension and Subsequent Incidence of Colorectal Cancer: Analysis of a Nationwide Epidemiological Database

Background Studies of the association of hypertension with incident colorectal cancer (CRC) may have been confounded by including individuals taking antihypertensive medication, at high risk for CRC (ie, colorectal polyps and inflammatory bowel disease), or with shared risk factors (eg, obesity and diabetes). We assessed whether adults with untreated hypertension are at higher risk for incident CRC compared with those with normal blood pressure (BP), and whether any association is evident among individuals without obesity or metabolic abnormalities. Methods and Results Analyses were conducted using a nationwide health claims database collected in the JMDC Claims Database between 2005 and 2018 (n=2 220 112; mean age, 44.1±11.0 years; 58.4% men). Participants who were taking antihypertensive medications or had a history of CRC, colorectal polyps, or inflammatory bowel disease were excluded. Each participant was categorized as having normal BP (systolic BP [SBP]