# Vascular Dysfunction in Colorectal Cancer: Scoping Review of Current Evidence for Guiding Future Research

## TL;DR

This review explores vascular health in colorectal cancer survivors, finding risks from treatments and surgery, and suggests future research directions.

## Contribution

The study identifies gaps in vascular function research among CRC survivors and proposes a research agenda to address these limitations.

## Key findings

- CRC survivors who underwent systemic treatment had increased arterial stiffness and atherosclerosis.
- Colon surgery was associated with endothelial dysfunction but not changes in arterial stiffness.
- Only seven studies were found measuring vascular function in CRC survivors, indicating limited research in this area.

## Abstract

We conducted a scoping review of research on vascular function (VF) in colorectal cancer (CRC) survivors and developed a research agenda to address current limitations.

We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Scoping Review (PRISMA-ScR) when conducting and reporting this review. We searched 3 databases (PubMed, EBSCOhost, and EMBASE) in October 2025 for publications on VF and vascular dysfunction (VD) that included measures of arterial stiffness and endothelial function in CRC survivors. There were 348 manuscripts identified for title and abstract screening, and 341 were excluded for not meeting the inclusion criteria.

Our search and subsequent screening identified seven papers reporting measures of VF in CRC survivors. Five papers focused on the impact of systemic therapies on measures of VF, including PWV and FMD, whereas two papers examined the effect of colon surgery on surrogate measures of VF. Increased arterial stiffness and atherosclerosis were observed following systemic treatment; however, endothelial function was inconsistent. Following colon surgery, endothelial function declined, while arterial stiffness remained unchanged.

CRC survivors who underwent systemic treatment had increased arterial stiffness and atherosclerosis, and those who underwent colon surgery had endothelial dysfunction. Overall, there is limited research on VF in CRC survivors, and we outline an agenda for future research to investigate VF in this population and address the numerous gaps in the field.

This review highlights that CRC survivors may experience vascular health risks following systemic therapy and colon surgery, emphasizing the need for improved VF monitoring and survivorship care.