Cancer Epidemiology Biomarkers & Prevention, Vol 6, Issue 12 1007-1010, Copyright © 1997 by American Association for Cancer Research

ARTICLES

Diabetes mellitus and colorectal cancer risk

C La Vecchia, E Negri, A Decarli and S Franceschi
Istituto di Ricerche Farmacologiche, Mario Negri, Milan, Italy.

The relationship between diabetes mellitus and the risk of colorectal cancer was investigated in a multicenter case-control study, conducted in Italy between 1992 and 1996 on 1225 cases of incident, histologically confirmed colon cancer, 728 cases of rectal cancer, and 4154 controls, who were in the hospital for acute, nonneoplastic diseases. Overall, 66 (5.4%) cases of colon cancer, 50 (6.9%) cases of rectal cancer, and 185 (4.4%) controls reported a history of diabetes. The corresponding multivariate odds ratios (ORs) were 1.2 [95% confidence interval (CI), 0.8-1.6] for colon, 1.5 (95% CI, 1.1-2.2) for rectal, and 1.3 (95% CI, 1.0-1.6) for all colorectal cancers. No association was observed for subjects who were diagnosed with diabetes at ages of < 40 years (7 cases and 27 controls, OR = 0.9). The OR was 1.4 (95% CI, 1.1-1.7) for subjects who were diagnosed with diabetes at ages of > or = 40 years and were likely to have non-insulin-dependent diabetes. The association was also stronger (OR = 1.6; 95% CI, 1.1-2.3) among subjects whose diabetes was diagnosed 10 or more years in advance and who were > or = 60 years old at the time of colorectal cancer diagnosis. None of the other covariates, including sex, education, body mass index, physical activity, energy intake, alcohol drinking, and fiber intake, showed any appreciable modifying effect. Thus, this uniquely large case-control study of colorectal cancer confirms that subjects with non-insulin-dependent diabetes mellitus have a slightly increased risk of colorectal cancer. More importantly, allowance for a large number of identified potential confounding factors, including body mass index, diet, and physical activity, could not explain the excess colorectal cancer risk among subjects with diabetes mellitus. These findings have plausible biological correlations because insulin-like-growth factor-I is a promoter of colon tumor cell growth in vitro.

This article has been cited by other articles:

				T. Mizoue, M. Inoue, K. Wakai, C. Nagata, T. Shimazu, I. Tsuji, T. Otani, K. Tanaka, K. Matsuo, A. Tamakoshi, et al. Alcohol Drinking and Colorectal Cancer in Japanese: A Pooled Analysis of Results from Five Cohort Studies Am. J. Epidemiol., June 15, 2008; 167(12): 1397 - 1406. [Abstract] [Full Text] [PDF]

				K. Bowers, D. Albanes, P. Limburg, P. Pietinen, P. R. Taylor, J. Virtamo, and R. Stolzenberg-Solomon A Prospective Study of Anthropometric and Clinical Measurements Associated with Insulin Resistance Syndrome and Colorectal Cancer in Male Smokers Am. J. Epidemiol., October 1, 2006; 164(7): 652 - 664. [Abstract] [Full Text] [PDF]

				S. C. Larsson, N. Orsini, and A. Wolk Diabetes Mellitus and Risk of Colorectal Cancer: A Meta-Analysis J Natl Cancer Inst, November 16, 2005; 97(22): 1679 - 1687. [Abstract] [Full Text] [PDF]

				A. Tavani, F. Bravi, C. Bosetti, S. Franceschi, F. Levi, R. Talamini, and C. La Vecchia Diabetes Mellitus and Subsite-Specific Colorectal Cancer Risks in the Iowa Women's Health Study Cancer Epidemiol. Biomarkers Prev., September 1, 2005; 14(9): 2277 - 2277. [Full Text] [PDF]

				D. S. Michaud, C. S. Fuchs, S. Liu, W. C. Willett, G. A. Colditz, and E. Giovannucci Dietary Glycemic Load, Carbohydrate, Sugar, and Colorectal Cancer Risk in Men and Women Cancer Epidemiol. Biomarkers Prev., January 1, 2005; 14(1): 138 - 147. [Abstract] [Full Text] [PDF]

				S. S. Coughlin, E. E. Calle, L. R. Teras, J. Petrelli, and M. J. Thun Diabetes Mellitus as a Predictor of Cancer Mortality in a Large Cohort of US Adults Am. J. Epidemiol., June 15, 2004; 159(12): 1160 - 1167. [Abstract] [Full Text] [PDF]

				K.-T. Khaw, N. Wareham, S. Bingham, R. Luben, A. Welch, and N. Day Preliminary Communication: Glycated Hemoglobin, Diabetes, and Incident Colorectal Cancer in Men and Women: A Prospective Analysis from the European Prospective Investigation into Cancer-Norfolk Study Cancer Epidemiol. Biomarkers Prev., June 1, 2004; 13(6): 915 - 919. [Abstract] [Full Text] [PDF]

				E. Cho, S. A. Smith-Warner, J. Ritz, P. A. van den Brandt, G. A. Colditz, A. R. Folsom, J. L. Freudenheim, E. Giovannucci, R. A. Goldbohm, S. Graham, et al. Alcohol Intake and Colorectal Cancer: A Pooled Analysis of 8 Cohort Studies Ann Intern Med, April 20, 2004; 140(8): 603 - 613. [Abstract] [Full Text] [PDF]

				J. Ma, E. Giovannucci, M. Pollak, A. Leavitt, Y. Tao, J. M. Gaziano, and M. J. Stampfer A Prospective Study of Plasma C-Peptide and Colorectal Cancer Risk in Men J Natl Cancer Inst, April 7, 2004; 96(7): 546 - 553. [Abstract] [Full Text] [PDF]

				D. B. Boyd Insulin and Cancer Integr Cancer Ther, December 1, 2003; 2(4): 315 - 329. [Abstract] [PDF]

				S. H. Saydah, E. A. Platz, N. Rifai, M. N. Pollak, F. L. Brancati, and K. J. Helzlsouer Association of Markers of Insulin and Glucose Control with Subsequent Colorectal Cancer Risk Cancer Epidemiol. Biomarkers Prev., May 1, 2003; 12(5): 412 - 418. [Abstract] [Full Text] [PDF]

				D. Komninou, A. Ayonote, J. P. Richie Jr., and B. Rigas Insulin Resistance and Its Contribution to Colon Carcinogenesis Experimental Biology and Medicine, April 1, 2003; 228(4): 396 - 405. [Abstract] [Full Text] [PDF]

				J. A. Meyerhardt, P. J. Catalano, D. G. Haller, R. J. Mayer, J. S. Macdonald, A. B. Benson III, and C. S. Fuchs Impact of Diabetes Mellitus on Outcomes in Patients With Colon Cancer J. Clin. Oncol., February 1, 2003; 21(3): 433 - 440. [Abstract] [Full Text] [PDF]

				R. J. Mitchell, S. M. Farrington, M. G. Dunlop, and H. Campbell Mismatch Repair Genes hMLH1 and hMSH2 and Colorectal Cancer: A HuGE Review Am. J. Epidemiol., November 15, 2002; 156(10): 885 - 902. [Abstract] [Full Text] [PDF]

				P. M. Brauer, G. E. McKeown-Eyssen, V. Jazmaji, A. G. Logan, D. F. Andrews, D. Jenkins, N. Marcon, F. Saibil, L. Cohen, H. Stern, et al. Familial Aggregation of Diabetes and Hypertension in a Case-Control Study of Colorectal Neoplasia Am. J. Epidemiol., October 15, 2002; 156(8): 702 - 713. [Abstract] [Full Text] [PDF]

				G. D. Girnun, W. M. Smith, S. Drori, P. Sarraf, E. Mueller, C. Eng, P. Nambiar, D. W. Rosenberg, R. T. Bronson, W. Edelmann, et al. APC-dependent suppression of colon carcinogenesis by PPARgamma PNAS, October 15, 2002; 99(21): 13771 - 13776. [Abstract] [Full Text] [PDF]

				L. O. Dragsted, B. Daneshvar, U. Vogel, H. N. Autrup, H. Wallin, L. Risom, P. Moller, A. M. Molck, M. Hansen, H. E. Poulsen, et al. A Sucrose-rich Diet Induces Mutations in the Rat Colon Cancer Res., August 1, 2002; 62(15): 4339 - 4345. [Abstract] [Full Text] [PDF]

				F Levi, C Pasche, F Lucchini, C La Vecchia, M S Sandhu, and K-T Khaw Diabetes mellitus, family history, and colorectal cancer J. Epidemiol. Community Health, June 1, 2002; 56(6): 479 - 480. [Full Text] [PDF]

				R. Kaaks, P. Toniolo, A. Akhmedkhanov, A. Lukanova, C. Biessy, H. Dechaud, S. Rinaldi, A. Zeleniuch-Jacquotte, R. E. Shore, and E. Riboli Serum C-Peptide, Insulin-Like Growth Factor (IGF)-I, IGF-Binding Proteins, and Colorectal Cancer Risk in Women J Natl Cancer Inst, October 4, 2000; 92(19): 1592 - 1600. [Abstract] [Full Text] [PDF]

				R. E. Schoen, C. M. Tangen, L. H. Kuller, G. L. Burke, M. Cushman, R. P. Tracy, A. Dobs, and P. J. Savage Increased Blood Glucose and Insulin, Body Size, and Incident Colorectal Cancer J Natl Cancer Inst, July 7, 1999; 91(13): 1147 - 1154. [Abstract] [Full Text] [PDF]

				F. B. Hu, J. E. Manson, S. Liu, D. Hunter, G. A. Colditz, K. B. Michels, F. E. Speizer, and E. Giovannucci Prospective Study of Adult Onset Diabetes Mellitus (Type 2) and Risk of Colorectal Cancer in Women J Natl Cancer Inst, March 17, 1999; 91(6): 542 - 547. [Abstract] [Full Text] [PDF]