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Diabetes mellitus and subsite-specific colorectal cancer risks in the Iowa Women's Health Study.
Cancer Epidemiol Biomarkers Prev. 2005 Jan; 14(1):133-7.CE

Abstract

OBJECTIVE

Controversy remains regarding the association between type 2 diabetes mellitus (DM) and colorectal cancer (CRC) risk. To clarify and extend the existing data, we prospectively evaluated the association between self-reported type 2 DM (onset at >30 years of age) and incident CRC, overall and by anatomic subsite, among postmenopausal women in the Iowa Women's Health Study (n = 35,230).

METHODS

After 14 years of follow-up, a total of 870 incident CRC cases were identified through annual linkage to the Iowa Cancer Registry. DM was analyzed as reported at baseline and as a time-dependent variable using information obtained during follow-up. CRC risks were estimated using Cox proportional hazards regression models.

RESULTS

After adjusting for age, body mass index and other potential confounding variables, the relative risk (RR) for women with DM versus women without DM was modestly increased at 1.4 [95% confidence interval (95% CI), 1.1-1.8]. By anatomic subsite, the RR for proximal colon cancer was statistically significantly increased (RR, 1.9; 95% CI, 1.3-2.6), whereas the RRs for distal colon (RR, 1.1; 95% CI, 0.6-1.8) and rectal cancer (RR, 0.8; 95% CI, 0.4-1.6) were not statistically different from unity. Analyses that included DM ascertained at baseline and follow-up yielded similar results.

CONCLUSION

In this large, prospective study of postmenopausal women, the association between DM and incident CRC was found to be subsite specific. If confirmed by others, this finding implies that CRC prevention strategies among type 2 DM patients should include examination of the proximal colon.

Authors+Show Affiliations

Division of Epidemiology, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, USA. limburg.paul@mayo.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15668486

Citation

Limburg, Paul J., et al. "Diabetes Mellitus and Subsite-specific Colorectal Cancer Risks in the Iowa Women's Health Study." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 14, no. 1, 2005, pp. 133-7.
Limburg PJ, Anderson KE, Johnson TW, et al. Diabetes mellitus and subsite-specific colorectal cancer risks in the Iowa Women's Health Study. Cancer Epidemiol Biomarkers Prev. 2005;14(1):133-7.
Limburg, P. J., Anderson, K. E., Johnson, T. W., Jacobs, D. R., Lazovich, D., Hong, C. P., Nicodemus, K. K., & Folsom, A. R. (2005). Diabetes mellitus and subsite-specific colorectal cancer risks in the Iowa Women's Health Study. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 14(1), 133-7.
Limburg PJ, et al. Diabetes Mellitus and Subsite-specific Colorectal Cancer Risks in the Iowa Women's Health Study. Cancer Epidemiol Biomarkers Prev. 2005;14(1):133-7. PubMed PMID: 15668486.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diabetes mellitus and subsite-specific colorectal cancer risks in the Iowa Women's Health Study. AU - Limburg,Paul J, AU - Anderson,Kristin E, AU - Johnson,Trista W, AU - Jacobs,David R,Jr AU - Lazovich,Deann, AU - Hong,Ching-Ping, AU - Nicodemus,Kristin K, AU - Folsom,Aaron R, PY - 2005/1/26/pubmed PY - 2005/4/21/medline PY - 2005/1/26/entrez SP - 133 EP - 7 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 14 IS - 1 N2 - OBJECTIVE: Controversy remains regarding the association between type 2 diabetes mellitus (DM) and colorectal cancer (CRC) risk. To clarify and extend the existing data, we prospectively evaluated the association between self-reported type 2 DM (onset at >30 years of age) and incident CRC, overall and by anatomic subsite, among postmenopausal women in the Iowa Women's Health Study (n = 35,230). METHODS: After 14 years of follow-up, a total of 870 incident CRC cases were identified through annual linkage to the Iowa Cancer Registry. DM was analyzed as reported at baseline and as a time-dependent variable using information obtained during follow-up. CRC risks were estimated using Cox proportional hazards regression models. RESULTS: After adjusting for age, body mass index and other potential confounding variables, the relative risk (RR) for women with DM versus women without DM was modestly increased at 1.4 [95% confidence interval (95% CI), 1.1-1.8]. By anatomic subsite, the RR for proximal colon cancer was statistically significantly increased (RR, 1.9; 95% CI, 1.3-2.6), whereas the RRs for distal colon (RR, 1.1; 95% CI, 0.6-1.8) and rectal cancer (RR, 0.8; 95% CI, 0.4-1.6) were not statistically different from unity. Analyses that included DM ascertained at baseline and follow-up yielded similar results. CONCLUSION: In this large, prospective study of postmenopausal women, the association between DM and incident CRC was found to be subsite specific. If confirmed by others, this finding implies that CRC prevention strategies among type 2 DM patients should include examination of the proximal colon. SN - 1055-9965 UR - https://www.unboundmedicine.com/medline/citation/15668486/Diabetes_mellitus_and_subsite_specific_colorectal_cancer_risks_in_the_Iowa_Women's_Health_Study_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&pmid=15668486 DB - PRIME DP - Unbound Medicine ER -