BACKGROUND: Many studies have provided evidence for an association between obesity, physical inactivity, and western diet as risk factors for colorectal cancer (CRC). Few studies directly address the association between type 2 Diabetes Mellitus (DM) and the risk of colorectal lesions at specific anatomic locations. METHODS: 2,663 subjects with a previous history of adenoma(s) and removal of all current adenomas at study entry were followed for a mean time of three years across three different chemoprevention clinical trials. The primary endpoint was colorectal adenoma recurrence and number of lesions during the treatment phase; the secondary endpoints were presence of advanced colorectal neoplasia (CRN) and location of CRN. Using log linear regression, the effect of DM status on the relative risk (RR) of CRN recurrence, advanced CRN, and location of CRN was assessed. RESULTS: DM status was not significantly associated with incidence of colorectal adenomas, incidence of advanced colorectal lesions, or left-sided colorectal neoplastic lesions. Subjects with DM had a marginally increased risk of right-sided (p= 0.06) colorectal adenomas and a significant increased risk of multiple right-sided adenomas (p=0.03) in the unadjusted model; this association was not significant after adjusting for age and other potential confounders (RR=1.22, 95% CI: 0.85-1.76). CONCLUSION: We did not observe a statistically significant increased risk in CRN recurrence for overall neoplasia, advanced neoplasia or location of neoplasia in individuals with DM compared to non-DM individuals. However, given the patterns observed in this investigation, future studies with longer follow-up time and longer DM exposure, incorporating objective measurements of type 2 DM might help elucidate the risk of CRN among individuals with DM.
BACKGROUND: Many studies have provided evidence for an association between obesity, physical inactivity, and western diet as risk factors for colorectal cancer (CRC). Few studies directly address the association between type 2 Diabetes Mellitus (DM) and the risk of colorectal lesions at specific anatomic locations. METHODS: 2,663 subjects with a previous history of adenoma(s) and removal of all current adenomas at study entry were followed for a mean time of three years across three different chemoprevention clinical trials. The primary endpoint was colorectal adenoma recurrence and number of lesions during the treatment phase; the secondary endpoints were presence of advanced colorectal neoplasia (CRN) and location of CRN. Using log linear regression, the effect of DM status on the relative risk (RR) of CRN recurrence, advanced CRN, and location of CRN was assessed. RESULTS:DM status was not significantly associated with incidence of colorectal adenomas, incidence of advanced colorectal lesions, or left-sided colorectal neoplastic lesions. Subjects with DM had a marginally increased risk of right-sided (p= 0.06) colorectal adenomas and a significant increased risk of multiple right-sided adenomas (p=0.03) in the unadjusted model; this association was not significant after adjusting for age and other potential confounders (RR=1.22, 95% CI: 0.85-1.76). CONCLUSION: We did not observe a statistically significant increased risk in CRN recurrence for overall neoplasia, advanced neoplasia or location of neoplasia in individuals with DM compared to non-DM individuals. However, given the patterns observed in this investigation, future studies with longer follow-up time and longer DM exposure, incorporating objective measurements of type 2 DM might help elucidate the risk of CRN among individuals with DM.
Authors: Katherine Bowers; Demetrius Albanes; Paul Limburg; Pirjo Pietinen; Phil R Taylor; Jarmo Virtamo; Rachael Stolzenberg-Solomon Journal: Am J Epidemiol Date: 2006-07-28 Impact factor: 4.897
Authors: John A Baron; Bernard F Cole; Robert S Sandler; Robert W Haile; Dennis Ahnen; Robert Bresalier; Gail McKeown-Eyssen; Robert W Summers; Richard Rothstein; Carol A Burke; Dale C Snover; Timothy R Church; John I Allen; Michael Beach; Gerald J Beck; John H Bond; Tim Byers; E Robert Greenberg; Jack S Mandel; Norman Marcon; Leila A Mott; Loretta Pearson; Fred Saibil; Rosalind U van Stolk Journal: N Engl J Med Date: 2003-03-06 Impact factor: 91.245
Authors: Paul J Limburg; Kristin E Anderson; Trista W Johnson; David R Jacobs; Deann Lazovich; Ching-Ping Hong; Kristin K Nicodemus; Aaron R Folsom Journal: Cancer Epidemiol Biomarkers Prev Date: 2005-01 Impact factor: 4.254
Authors: J A Baron; M Beach; J S Mandel; R U van Stolk; R W Haile; R S Sandler; R Rothstein; R W Summers; D C Snover; G J Beck; H Frankl; L Pearson; J H Bond; E R Greenberg Journal: Ann N Y Acad Sci Date: 1999 Impact factor: 5.691
Authors: Kay-Tee Khaw; Nicholas Wareham; Sheila Bingham; Robert Luben; Ailsa Welch; Nicholas Day Journal: Cancer Epidemiol Biomarkers Prev Date: 2004-06 Impact factor: 4.254
Authors: Yaritza Díaz-Algorri; María Eugenia Lozada; Sofía M López; Carlos E Bertrán-Rodríguez; Cinthia M González-Hernández; Dilka González; Cynthia M Pérez-Cardona; Jessica Hernández; Carmen Pedrosa; Doris H Toro; María González-Pons; Marcia Cruz-Correa Journal: J Diabetes Complications Date: 2015-02-03 Impact factor: 2.852