DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20202454

Type 2 diabetes mellitus: a risk indicator for colorectal cancer

Sabrina Ahmed, Salamat Khandker, A. B. M. Alauddin Chowdhury, Naym Uddin Roby, Katsuyuki Miura, M. S. A. Mansur Ahmed

Abstract


Background: Worldwide, colorectal cancer is the fourth most common cancer and affects both men and women equally. Increasing evidence suggests that abnormal glucose metabolism may be associated with increased risk of colorectal cancer. The aim of this case control study was to determine the association of colorectal cancer with type 2 diabetes mellitus (T2 DM) and other risk factors of colorectal cancer among adult Bangladeshi population.

Methods: We included patients of colorectal cancer as cases and the controls were mostly cancer patients other than colorectal cancer and relatives of the patients attending in National Institute of Cancer Research Hospital (NICRH) in Dhaka. Three hundred samples (100 cases and 200 controls) were selected purposively.

Results: It was found that in cases 19% participants had T2 DM before colorectal cancer whereas 10.5% participants in controls had similar history. Appropriate statistical analysis reported that cases having T2 DM has 2.86 times higher chance to develop colorectal cancer (OR 2.68, 95% CI: 1.21-5.96) compared to controls. We also got significant inverse association with colorectal cancer with obesity (OR 0.43, 95% CI: 0.19-0.97), positive smoking history (OR 0.32, 95% CI: 0.19-0.60) and low fruits and vegetable intake (OR 0.33, 95% CI: 0.19-0.60).

Conclusions: This was a unique study for Bangladesh which showed results consistent with the finding of studies done globally. Therefore, we accept our research hypothesis as T2 DM is a risk indicator for colorectal cancer, however obesity, smoking and less fruits and vegetable intake are also risk factors for colorectal cancer among Bangladeshi population.


Keywords


Colorectal cancer, Type 2 diabetes mellitus, Risk indicator

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References


Kramer HU, Schottker B, Raum E, Brenner H. Type 2 diabetes mellitus and colorectal cancer: Meta-analysis on sex-specific differences. Eur J Cancer. 2012;48(9):1269-82.

WHO Global Report. Global Report on Diabetes. Available at: http://www.who.int/about/licensing. Accessed on 3 January 2020.

Guraya SY. Clinicopathological features and the outcome of surgical management for adenocarcinoma of the appendix. World J Gastrointest Surg. 2011;3(1):7.

Services DG of H, National Cancer Control Strategy and Plan of Action 2009-15. Minist Heal Fam Welfare, Bangladesh. Available at http://www.ban. searo.who.int/LinkFiles/Publication_Cancer_Strategy.pdf. Accessed on 3 January 2020.

Margaret McDonald, Robin P. Hertz SWPL. The Burden of Cancer in Asia. Pfizer Facts; 2008.

Peeters PJHL, Bazelier MT, Leufkens HGM, Vries DF, Bruin DML. The risk of colorectal cancer in patients with type 2 Diabetes: Associations with treatment stage and obesity. Diabetes Care. 2015;38(3):495-502.

Zendehdel K. Cancer Incidence in Patients with Type 1 diabetes mellitus: A Population-Based Cohort Study in Sweden. Cancer Spectrum Knowl Environ. 2003;95(23):1797-800.

Yin S, Bai H, Jing D. Insulin therapy and colorectal cancer risk among type 2 diabetes mellitus patients: A systemic review and meta-analysis. Diagn Pathol. 2014;9(1):1-6.

Sieber OM, Lipton L, Crabtree M, Heinimann K, Fidalgo P, Phillips RKS, et al. Multiple colorectal adenomas, classic adenomatous polyposis, and germ-line mutations in MYH. N Engl J Med. 2003;348(9):791-9.

Hypertension in adults: diagnosis and management Guidance NICE. Available at https://www.nice.org. uk/guidance/ng136. Accessed on 23rd March 2020.

Vecchia LC, Negri E, Decarli A, Franceschi S. Diabetes mellitus and colorectal cancer risk. Cancer Epidemiol Biomarkers Prev. 1997;6(12):1007-10.

Larsson SC, Orsini N, Wolk A. Diabetes mellitus and risk of colorectal cancer: A meta-analysis. J Natl Cancer Inst. 2005;97(22):1679-87.

Levi F, Pasche C, Lucchini F, Vecchia LC. Diabetes mellitus, family history, and colorectal cancer. J Epidemiol Community Health. 2002;56(6):479-80.

World Cancer Research Fund AI for CR. Diet, nutrition, physical activity and colorectal cancer: Continuous Update Project 2017. 2017;111. Available from: http://www.aicr.org/continuous-update-project/reports/colorectal-cancer-2017-report.pdf. Accessed on 3 January 2020.

Harriss D, Atkinson G, Batterham A, George K, Cable N, Reilly T, et al. Lifestyle factors and colorectal cancer risk (2): a systematic review and meta-analysis of associations with leisure-time physical activity. Colorectal Dis. 2009;11:689-701.

Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, et al. Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA Intern Med. 2016;176(6):816-25.

Samad AKA, Taylor RS, Marshall T, Chapman MAS. A meta-analysis of the association of physical activity with reduced risk of colorectal cancer. Colorectal Dis. 2005;7:204-13.

Wolin KY, Yan Y, Colditz GA, Lee IM. Physical activity and colon cancer prevention: A meta-analysis. Br J Cancer. 2009;100(4):611-6.

Cho YA, Lee J, Oh JH, Chang HJ, Sohn DK, Shin A, et al. Genetic Risk Score, Combined Lifestyle Factors and Risk of Colorectal Cancer. Cancer Res Treat. 2019;51(3):1033-40.

Dashti SG, Win AK, Hardikar SS, Glombicki SE, Mallenahalli S, Thirumurthi S, et al. Physical activity and the risk of colorectal cancer in Lynch syndrome. Int J Cancer. 2018;143(9):2250-60.