Jessica Chubak1,2, Onchee Yu3, Rebecca A Ziebell3, Erin J Aiello Bowles3, Andrew T Sterrett4, Monica M Fujii3, Jennifer M Boggs4, Andrea N Burnett-Hartman4, Denise M Boudreau3,5,6, Lu Chen3, James S Floyd5,7, Debra P Ritzwoller4, Rebecca A Hubbard8. 1. Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA. Jessica.Chubak@kp.org. 2. Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA. Jessica.Chubak@kp.org. 3. Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA. 4. Kaiser Permanente Colorado Institute for Health Research, Denver, CO, USA. 5. Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA. 6. School of Pharmacy, University of Washington, Seattle, WA, USA. 7. Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA. 8. Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Abstract
PURPOSE: To describe the association between diabetes and colon cancer recurrence. METHODS: We conducted a cohort study at two integrated health care delivery systems in the United States. Using tumor registry data, we identified patients aged ≥ 18 years when diagnosed with stage I-IIIA adenocarcinomas of the colon during 1995-2014. Pre-existing diabetes was ascertained via diagnosis codes. Medical records were reviewed for eligibility and to abstract recurrence and covariate information. Recurrence was ascertained beginning 90 days after the end of colon cancer treatment (i.e., cohort entry). Recurrence of any cancer or a new primary cancer at any site was a secondary outcome. We used multivariable Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CIs) for the associations between diabetes at cohort entry and study outcomes. RESULTS: Among the 1,923 eligible patients, 393 (16.7%) had diabetes at cohort entry. Diabetes was not associated with recurrence (HR 0.87; 95% CI 0.56-1.33) or with any subsequent cancer (HR 1.09; 95% CI 0.85-1.40). When the definition of recurrence included second primary colorectal cancer, risk was non-significantly higher in patients with diabetes than without diabetes. CONCLUSIONS: The risk of colon cancer recurrence appears to be similar in patients with and without diabetes at diagnosis. IMPACT: Future studies should evaluate the association between diabetes and colorectal cancer outcomes, especially second primary colon cancers, in larger populations.
PURPOSE: To describe the association between diabetes and colon cancer recurrence. METHODS: We conducted a cohort study at two integrated health care delivery systems in the United States. Using tumor registry data, we identified patients aged ≥ 18 years when diagnosed with stage I-IIIA adenocarcinomas of the colon during 1995-2014. Pre-existing diabetes was ascertained via diagnosis codes. Medical records were reviewed for eligibility and to abstract recurrence and covariate information. Recurrence was ascertained beginning 90 days after the end of colon cancer treatment (i.e., cohort entry). Recurrence of any cancer or a new primary cancer at any site was a secondary outcome. We used multivariable Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CIs) for the associations between diabetes at cohort entry and study outcomes. RESULTS: Among the 1,923 eligible patients, 393 (16.7%) had diabetes at cohort entry. Diabetes was not associated with recurrence (HR 0.87; 95% CI 0.56-1.33) or with any subsequent cancer (HR 1.09; 95% CI 0.85-1.40). When the definition of recurrence included second primary colorectal cancer, risk was non-significantly higher in patients with diabetes than without diabetes. CONCLUSIONS: The risk of colon cancer recurrence appears to be similar in patients with and without diabetes at diagnosis. IMPACT: Future studies should evaluate the association between diabetes and colorectal cancer outcomes, especially second primary colon cancers, in larger populations.
Authors: Jessica Chubak; Rebecca Ziebell; Robert T Greenlee; Stacey Honda; Mark C Hornbrook; Mara Epstein; Larissa Nekhlyudov; Pamala A Pawloski; Debra P Ritzwoller; Nirupa R Ghai; Heather Spencer Feigelson; Heather A Clancy; V Paul Doria-Rose; Lawrence H Kushi Journal: Cancer Causes Control Date: 2016-09-17 Impact factor: 2.506
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Authors: Gaia Pocobelli; Onchee Yu; Rebecca A Ziebell; Erin J Aiello Bowles; Monica M Fujii; Andrew T Sterrett; Jennifer M Boggs; Lu Chen; Denise M Boudreau; Debra P Ritzwoller; Rebecca A Hubbard; Jessica Chubak Journal: Psychooncology Date: 2019-02-14 Impact factor: 3.894
Authors: Lu Chen; Jessica Chubak; Onchee Yu; Gaia Pocobelli; Rebecca A Ziebell; Erin J Aiello Bowles; Monica M Fujii; Andrew T Sterrett; Jennifer M Boggs; Andrea N Burnett-Hartman; Debra P Ritzwoller; Rebecca A Hubbard; Denise M Boudreau Journal: Cancer Causes Control Date: 2019-10-30 Impact factor: 2.506
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