Diabetes Mellitus and Site-specific Colorectal Cancer Risk in Korea: A Case-control Study

Abstract

Objectives:Previous large-scale cohort studies conducted in Korea have found a positive association between diabetes mellitus (DM) and colorectal cancer (CRC) in men only, in contrast to studies of other populations that have found significant associations in both men and women.Methods:A total of 1070 CRC cases and 2775 controls were recruited from the National Cancer Center, Korea between August 2010 and June 2013. Self-reported DM history and the duration of DM were compared between cases and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by binary and polytomous logistic regression models.Results:DM was associated with an elevated risk of CRC in both men (OR, 1.47; 95% CI, 1.13 to 1.90) and women (OR, 1.92; 95% CI, 1.24 to 2.98). This association remained when we controlled for age, body mass index, alcohol consumption, and physical activity level. In sub-site analyses, DM was associated with distal colon cancer risk in both men (multivariate OR, 2.04; 95% CI, 1.39 to 3.00) and women (multivariate ORs, 1.99; 95% CI, 1.05 to 3.79), while DM was only associated with rectal cancer risk in women (multivariate OR, 2.05; 95% CI, 1.10 to 3.82). No significant association was found between DM and proximal colon cancer risk in either men (multivariate OR, 1.45; 95% CI, 0.88 to 2.41) or women (multivariate OR, 1.79; 95% CI, 0.78 to 4.08).Conclusions:Overall, DM was associated with an increased risk of CRC in Koreans. However, potential over-estimation of the ORs should be considered due to potential biases from the case-control design.

Sex- and site-specific differences in colorectal cancer risk among people with type 2 diabetes

“…The majority of these studies among people with T2D showed a higher increased risk of proximal colon cancer in women with T2D (HR ranging from 1.6 to 1.8) than men with T2D (HR ranging from 1.4 to 1.6) compared to diabetes free controls, which is consistent with our finding [ 11 , 23 – 25 , 27 ]. One study [ 26 ] found, compared to diabetes free controls, a higher increased risk of overall, proximal, and distal CRC among men than women.…”

“…Four of these studies [23, 25–27] found higher risks of distal colon cancer among men (HR ranging from 1.3 to 2.1) than women (HR ranging from 0.7 to 2.0). The other two studies [11, 24] found a higher risk of distal colon cancer among women than among men, but the results of these studies were not statistically significant.…”

Utilization of Colorectal Cancer Screening among Saudi Elderly Population: A Study from the Saudi National Survey for Elderly Health

“…(Blom et al, 2008;Kuan-Chi, 2010;van Jaarsveld et al, 2006) Several studies reported that DM might increase the risk of colorectal cancer. (Guraya, 2015;Sun and Yu, 2012;Woo et al, 2016;Wu et al, 2013) In this cohort, people with diabetes were 37% more likely to perform CRCS. Nevertheless, DM did not show a significant effect on the odds of CRCS (OR=1.37; 95CI%: 0.97-1.94) which could be due to low health literacy among subjects as almost 70% of subjects were illiterate.…”

Diabetes-induced mechanophysiological changes in the small intestine and colon

“…Large prospective studies have demonstrated that DM is associated with an increased risk of colon cancer in people investigated[211-217]. Many meta-analysis studies also support a correlation between DM and increased risk of colon cancer[142-144,218-222].…”