Diabetes association of polyps and colon cancer

Miłek, Tomasz; Forysiński, Karol; Myrcha, Piotr; Ciostek, Piotr

doi:10.5604/01.3001.0013.2588

Cited by 38 publications

(20 citation statements)

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“…This indicates that diabetic patients are at a higher risk of developing colorectal cancer, thus are in higher need for controlled colonoscopy. 16,17 However, these facts may suggest further considerations when assessing diabetic patients with colon cancer in terms of clinical features, treatment, and prognosis.…”

Section: Discussionmentioning

confidence: 99%

Utility of KRAS Gene and Clinicopathological Features in the Assessment of the Risk of Type 2 Diabetes in the Etiology of Colon Cancer

Al-Qahtani

Al-Olayan

Albani

et al. 2020

Global Medical Genetics

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Background Cancer and diabetes have a tremendous impact on health globally. This study aimed to evaluate the KRAS gene in colon cancer tissues obtained from patients with type 2 diabetes mellitus (T2DM). Methodology Data from 315 cases (156 colon diabetics and 159 patients were nondiabetics) were retrospectively retrieved. mRNA from surgically resected colon cancer tumors were also retrieved. Results The expression of KRAS mRNA was significantly higher in patients afflicted with T2DM than nondiabetic patients. The KRAS mRNA levels were significantly amplified from primary to metastatic lesions (p < 0.001). Conclusion The association between T2DM and colon cancer was well-established in the present study.

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Section: Discussionmentioning

confidence: 99%

Utility of KRAS Gene and Clinicopathological Features in the Assessment of the Risk of Type 2 Diabetes in the Etiology of Colon Cancer

Al-Qahtani

Al-Olayan

Albani

et al. 2020

Global Medical Genetics

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“…Stage 2 CRC was more frequently diagnosed in T2D patients and stage 1 CRC, in nondiabetic patients (Van De Poll-Franse et al 2007). In support of epidemiological data, analysis of 976 colonoscopies showed that T2D patients exhibit a higher incidence of polyps and higher-grade dysplasia/ carcinoma (even higher in uncontrolled diabetes) when compared to nondiabetic patients (Miłek et al 2019). Although T2D is associated to higher grade CRC, it has not been associated to particular molecular subtypes of CRC (CMS) as summarized (Gutiérrez-Salmerón et al 2021).…”

Section: Introductionmentioning

confidence: 87%

Remodelling of colorectal cancer cell signaling by microbiota and immunity in diabetes

Gutiérrez-Salmerón

Lucena

Chocarro-Calvo

et al. 2021

Endocrine-Related Cancer

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Obesity is the strongest known risk factor to develop Type 2 diabetes (T2D) and both share a state of chronic, diffuse and low-grade inflammation, impaired immune responses and alterations in the composition and function of the microbiome. Notably, these hallmarks are shared with colorectal cancer (CRC), which is epidemiologically associated to obesity and T2D. Gut barrier damages in T2D, destabilize the microbiome that metabolizes the diet and modulates the host immune response triggering inflammatory and proliferative pathways. In this review, we discuss the pathways altered by defects in the immune response and microbiota that may link T2D to CRC development. Stressed adipocytes, metabolic incongruity in blood and gut barrier failure with dysbiosis cooperate to establish imbalances between immune innate and adaptive cells and cytokines such as interleukin 6 (IL-6) or tumour necrosis factor α (TNF-α) that define low-grade diffuse inflammation in T2D. Inflammation drives tissue repair through proliferation and migration (critical mechanisms for tumourigenesis) and under physiological conditions feeds anti-inflammatory cytokine production to resolve the process. The disproportion in pro- versus anti-inflammatory cells and cytokines imposed by T2D will impact the tumour micro- and macro-environment, favouring tumour proliferation, angiogenesis and decreased immune responses. Complex bidirectional relationships between the metabolic environment of T2D, gut microbiota, and immune dysfunctions may favour tumour cell demands and will define the outcome. Animal models developed to study the relationships between T2D and CRC in the context of microbiota and immune system are discussed.

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“…Several previous studies have reported an increased risk of CRC in patients with T2D. 21–24 46–51 However, only limited knowledge on the impact of T2D on PCCRC risk exists. 17 In line with our findings, a Swedish study by Forsberg et al suggested a slightly increased relative risk of PCCRC in diabetic patients (1.13, 95% CI 0.99 to 1.30).…”

Section: Discussionmentioning

confidence: 99%

Risk of a post-colonoscopy colorectal cancer in patients with type 2 diabetes: a Danish population-based cohort study

Troelsen

Sørensen

Pedersen

et al. 2021

BMJ Open Gastroenterol

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ObjectivePrevalent type 2 diabetes (T2D) is associated with an increased risk of colorectal cancer and could impair the quality of bowel preparation for colonoscopy. This may in turn increase the risk of overlooked precancerous polyps and subsequent risk of post-colonoscopy colorectal cancer (PCCRC). We investigated whether patients with T2D are at increased risk of PCCRC compared with patients without T2D.DesignWe conducted a population-based cohort study of patients with T2D and without T2D undergoing colonoscopy in Denmark (1995–2015). We investigated the risk of PCCRC by calculating >6 to 36 months cumulative incidence proportions (CIPs) treating death and colectomy as competing risks. Using Cox proportional-hazards regression analyses, we also computed HRs of PCCRC, comparing patients with T2D and non-T2D. According to the World Endoscopy Organization guidelines, we calculated PCCRC 3-year rates to estimate the proportions of T2D and non-T2D CRC patients experiencing PCCRC.ResultsWe identified 29 031 patients with T2D and 333 232 patients without T2D undergoing colonoscopy. We observed 250 PCCRCs among patients with T2D and 1658 PCCRCs among patients without T2D. The >6 to 36 months CIP after a first-time colonoscopy was 0.64% (95% CI 0.55% to 0.74%) for T2D and 0.36% (95% CI 0.34% to 0.38%) for patients without T2D. The HRs of PCCRC were 1.43 (95% CI 1.21 to 1.72) after a first-time colonoscopy and 1.18 (95% CI 0.75 to 1.85) after a second-time colonoscopy. The PCCRC 3-year rate was 7.9% for patients with T2D and 7.4% for patients without T2D.ConclusionT2D may be associated with an increased HR of PCCRC.

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Diabetes association of polyps and colon cancer

Cited by 38 publications

References 0 publications

Utility of KRAS Gene and Clinicopathological Features in the Assessment of the Risk of Type 2 Diabetes in the Etiology of Colon Cancer

Utility of KRAS Gene and Clinicopathological Features in the Assessment of the Risk of Type 2 Diabetes in the Etiology of Colon Cancer

Remodelling of colorectal cancer cell signaling by microbiota and immunity in diabetes

Risk of a post-colonoscopy colorectal cancer in patients with type 2 diabetes: a Danish population-based cohort study

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