Type 2 diabetes mellitus associated with increased risk for colorectal cancer: Evidence from an international ecological study and population-based risk analysis in China

Ren, X.; Zhang, X.; Zhang, X.; Gu, W.; Chen, K.; Le, Y.; Lai, M.; Zhu, Y.

doi:10.1016/j.puhe.2009.06.019

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Volume 123, Issue 8 , Pages 540-544, August 2009

Type 2 diabetes mellitus associated with increased risk for colorectal cancer: Evidence from an international ecological study and population-based risk analysis in China

X. Ren
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, 388 Yu-Hang-Tang Road, Hangzhou 310058, Zhejiang, PR China
X. Zhang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, 388 Yu-Hang-Tang Road, Hangzhou 310058, Zhejiang, PR China
X. Zhang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, 388 Yu-Hang-Tang Road, Hangzhou 310058, Zhejiang, PR China
- Hangzhou Centers of Disease Prevention and Control, Hangzhou 31006, PR China
W. Gu
- Jiaxing Centers of Disease Prevention and Control, Jiaxing 314050, PR China
K. Chen
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, 388 Yu-Hang-Tang Road, Hangzhou 310058, Zhejiang, PR China
Y. Le
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, 388 Yu-Hang-Tang Road, Hangzhou 310058, Zhejiang, PR China
M. Lai
- Center for Environmental Genomics, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, PR China
Y. Zhu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, 388 Yu-Hang-Tang Road, Hangzhou 310058, Zhejiang, PR China
- Corresponding author. Tel.: +86 571 88208362; fax: +86 571 88208198.

Received 12 February 2009; received in revised form 1 June 2009; accepted 26 June 2009. published online 07 August 2009.

Summary

Objective

To study the association between type 2 diabetes mellitus (T2DM) and colorectal cancer (CRC).

Study design

An international ecological study and a population-based risk analysis.

Methods

Prevalence data for T2DM and incidence data for CRC were collected from 170 countries, and Spearman's correlation was calculated between T2DM and CRC. In the Nan-Hu district of Jia-Xing city, Zhejiang province, China, the incidence of CRC among T2DM patients between 1 January 2002 and 30 June 2002 was identified through record linkage between the Diabetic Surveillance and Registry Database with the Cancer Surveillance and Registry Database. Standardized incidence ratios (SIRs) and 95% confidence intervals were used to estimate the risk of CRC among T2DM patients.

Results

Significant positive correlations (r_s=0.534 and 0.597 in males and females, respectively) were found between the prevalence of T2DM and the incidence of CRC. Sixty-four cases of CRC were found among 7938 T2DM patients. The SIR for CRC among T2DM patients was 1.588 (95% CI 1.199–1.977). For male T2DM patients, the SIR for CRC was 1.821 (95% CI 1.234–2.408), compared with 1.364 (95% CI 0.85–1.879) among female T2DM patients. Significant increased risks for colon cancer were found, with an SIR of 1.899 (95% CI 1.139–2.658) in male T2DM patients. Female T2DM patients showed a borderline significant risk for colon cancer, with an SIR of 1.687 (95% CI 0.948–2.426). However, no significant associations were found between T2DM and risk for rectal cancer among males (SIR 1.723, 95% CI 0.786–2.66) or females (SIR 0.906, 95% CI 0.235–1.578) (all P>0.05).