Ren X, Zhang X, Zhang X, Gu W, Chen K, Le Y, Lai M, Zhu Y
Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, PR China.
Public Health. 2009 Aug;123(8):540-4. doi: 10.1016/j.puhe.2009.06.019. Epub 2009 Aug 6.
To study the association between type 2 diabetes mellitus (T2DM) and colorectal cancer (CRC).
An international ecological study and a population-based risk analysis.
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.
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).
T2DM was associated with increased risk for CRC, and this association was more evident for colon cancer and among male diabetic patients.
研究2型糖尿病（T2DM）与结直肠癌（CRC）之间的关联。
一项国际生态学研究和基于人群的风险分析。
收集了170个国家的T2DM患病率数据和CRC发病率数据，并计算了T2DM与CRC之间的Spearman相关性。在中国浙江省嘉兴市南湖地区，通过糖尿病监测与登记数据库与癌症监测与登记数据库之间的记录链接，确定了2002年1月1日至2002年6月30日期间T2DM患者中CRC的发病率。采用标准化发病率比（SIRs）和95%置信区间来估计T2DM患者中CRC的风险。
发现T2DM患病率与CRC发病率之间存在显著正相关（男性r(s)=0.534，女性r(s)=0.597）。在7938例T2DM患者中发现了64例CRC病例。T2DM患者中CRC的SIR为1.588（95%CI 1.199 - 1.977）。男性T2DM患者中CRC的SIR为1.821（95%CI 1.234 - 2.408），而女性T2DM患者中为1.364（95%CI 0.85 - 1.879）。发现男性结肠癌风险显著增加，男性T2DM患者的SIR为1.899（95%CI 1.139 - 2.658）。女性T2DM患者结肠癌风险呈临界显著，SIR为1.687（95%CI 0.948 - 2.426）。然而，在男性（SIR 1.723，95%CI 0.786 - 2.66）或女性（SIR 0.906，95%CI 0.235 - 1.578）中，未发现T2DM与直肠癌风险之间存在显著关联（所有P>·05）。
T2DM与CRC风险增加相关，这种关联在结肠癌和男性糖尿病患者中更为明显。
