Issue 158 Item 9 Diabetes Raises Risk of Colon Cancer

Diabetes appears to raise the risk of developing colon cancer, suggest the findings from a retrospective case-control study. Rambabu Chalasani, MD, Emergency Medicine and Acute Care Physician, Overton Brooks VA Medical Center, Shreveport, Louisiana, said that a number of striking associations between diabetes and colon cancer led the researchers to perform the study.

“The risk factors for the two conditions are remarkably similar: high body mass index, increased central obesity, and sedentary lifestyles,” he said. “Both disorders are tied to industrialization, with the highest incidence in developed nations.”

Mechanistically, there is growing evidence of a link between high levels of insulin and increased levels of growth factors that can promote colon cancer, Dr. Chalasani added.

To explore the association further, Dr. Chalasani and colleagues evaluated the medical records of 50,697 patients between October, 1998 and June, 2003; about one-fifth suffered from diabetes. The mean age of the patients was 60 years, and 91% were male.

Multiple logistic regression analysis adjusted for obesity, smoking, use of aspirin, and alcohol consumption showed that those who had diabetes were 32% more likely to develop colon cancer, compared with people without diabetes (95% CI 1.12 to 1.55). Also, alcohol consumption was associated with a 33% increased risk (95% CI 1.11 to 1.61) and obesity was associated with a 28% increased risk (95% CI 1.09 to 1.51), Dr. Chalasani reported.

While the findings still have to be confirmed in a prospective study, he said that if the link is proven, people with diabetes should be offered screening for colon cancer at an earlier age and more often than people without the disorder. While awaiting further study, clinicians should be aware of the similarities in risk factors for the two conditions, he added. Presented at Digestive Disease Week 2004.

[Presentation title: “Diabetes mellitus is a risk factor for colon cancer: a case control study.” Abstract #104019]

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