Publication:


abstract

AIM:

the purpose of this study was to determine whether Diabetes Mellitus is associated with an increased risk of Colorectal Cancer.

METHODS:

Relevant studies were identified in MEDLINE and EMBASE (up until November 1st, 2011). Inclusion criteria were original, peer-Reviewed publications, with case-control and cohort studies (for studies on diabetes mellitus and colorectal cancer). Summary relative risks with 95% confidence intervals were calculated with a random-effects model.

RESULTS:

Twenty-four studies including eight case-control and 16 cohort studies, with a total of 3,659,341 participants, were included in this Updated Systematic review and Meta-Analysis, and all involved diabetes mellitus and colorectal cancer risk. Meta-analysis of the 24 included studies indicated that diabetes was associated with an increased risk of colorectal cancer, compared with no diabetes (summary RR of colorectal cancer Incidence = 1.26, 95% CI = 1.20-1.31), without heterogeneity between studies (P (heterogeneity) = 0.296). Sub-group analyses found that these results were consistent between case-control and cohort studies and among studies conducted in different areas. The association between diabetes and colorectal cancer incidence did not differ significantly by sex and sub-sites. Insulin therapy was also positively associated with risk of colorectal cancer (summary RR = 1.61, 95% CI 1.18-1.35), with evidence of heterogeneity between studies (P (heterogeneity) = 0.014).

CONCLUSIONS:

Our findings further support a relationship between diabetes and increased risk of colon and rectal cancer in both women and men, and insulin therapy for diabetes may increase this risk.

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