Abstract
Objectives
To assess the effect of diabetes mellitus (DM) on the pathogenesis and outcomes from colon cancer.
Methods
A retrospective chart review was conducted on 1853 patients with colon cancer.
Results
A higher percentage of males than females with colon cancer had DM (16.2% vs 11.3%; p<0.01). Males had a slightly lower risk of dying from colon cancer (RR−0.88; p=0.08). There was no difference in the median age of diagnosis of colon cancer in patients with and without DM, but a larger proportion of patients with diabetes mellitus were ≥70 yr at diagnosis (50% vs 43%) (p=0.0004). No significant relationship was noted between stage of colon cancer or survival and presence of DM.
Conclusions
DM did not affect either the stage at diagnosis, or outcomes from colon cancer. More males with colon cancer tended to have DM and a larger proportion of patients with DM were ≥70 yr at the time of diagnosis.
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References
Boyle P, Leon ME. Epidemiology of colorectal cancer. Br Med Bull 2002;64:1–25.
American Cancer Society. Cancer Facts & Figures 2005. Available at: http://www.cancer.org/downloads/STT/CAFF. Accessed March 10, 2005.
Giovannucci E. Insulin and colon cancer. Cancer Causes Control 1995;6:164–179.
McKeown-Eyssen G. Epidemiology of colorectal cancer revisited: are serum triglycerides and/or plasma glucose associated with risk? Cancer Epidemiol Biomark Prev 1994;3:687–695.
Komninou D, et al. Insulin resistance and its contribution to colon carcinogenesis. Exp Biol Med (Maywood) 2003; 228:396–405.
Chang CK, Ulrich CM. Hyperinsulinaemia and hyperglycaemia: possible risk factors of colorectal cancer among diabetic patients. Diabetologia 2003;46(5):595–607.
Coughlin SS, et al. Diabetes mellitus as a predictor of cancer mortality in a large cohort of US adults. Am J Epidemiol 2004;159:1160–1167.
Meyerhardt JA, et al. Impact of DM on outcomes in patients with colon cancer. J. Clin Oncol 2003;21:433–440.
Limburg PJ, et al. DM mellitus and subsite-specific colorectal cancer risks in the Iowa women's health study. Cancer Epidemiol Biomarkers Prev 2005;14:133–137.
Nilsen TI, Vatten LJ. Prospective study of colorectal cancer risk and physical activity, diabetes, blood glucose and BMI: exploring the hyperinsulinaemia hypothesis. Br J Cancer 2001;84:417–422.
Khaw KT, et al. Preliminary communication: glycated hemoglobin, DM, and incident colorectal cancer in men and women: a prospective analysis from the European prospective investigation into cancer-Norfolk study. Cancer Epidemiol Biomarkers Prev 2004;13:915–919.
Kune GA, Kune S, Watson LF. Colorectal cancer risk, chronic illnesses, operations, and medications: case control results from the Melbourne Colorectal Cancer Study. Cancer Res 1988;48:4399–4404.
De Marco MF, et al. Comorbidity and colorectal cancer according to subsite and stage: a population-based study. Eur J Cancer 2000;36:95–99.
Estimates of diabetes prevalence by county. North Dakota diabetes prevention and control program, http://diabetesnd. org/impact.html, 2003, pp. 1–7.
Will JC, et al. Colorectal cancer: another complication of DM mellitus? Am J Epidemiol 1998;147:816–825.
Hannele YJ. Thiazolidinediones. N Engl J Med 2004; 351:1106–1117.
Sarraf P, et al. Differentiation and reversal of malignant changes in colon cancer through PPARγ. Nat Med 1998; 4:1046–1052.
Koohestani N, et al. Insulin resistance and promotion of aberrant crypt fociin the colons of rats on a high-fat diet. Nutr Cancer 1997;29:69–76.
Auwerx J. Nuclear receptors. I. PPAR γ in the gastrointestinal tract: gain or pain? Am J Physiol Gastrointest Liver Physiol 2002;282(4):G581–585.
Lefebvre A, et al. Activation of the peroxisome proliferator-activated receptor γ promotes the development of colon tumors in C57BL/6J-APCMin/+ mice. Nat Med 1998; 4:1053–1057.
Saez E, et al. Activators of the nuclear receptor PPARγ enhance colon polyp formation. Nat Med 1998;4:1058–1061.
Hu FB, et al. Prospective study of adult onset DM mellitus (type 2) and risk of colorectal cancer in women. J Natl Cancer Inst 1999;91:542–547.
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Shonka, N.A., Anderson, J.R., Panwalkar, A.W. et al. Effect of diabetes mellitus on the epidemiology and outcomes of colon cancer. Med Oncol 23, 515–519 (2006). https://doi.org/10.1385/MO:23:4:515
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DOI: https://doi.org/10.1385/MO:23:4:515