Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
Eur J Cancer. 2012 Jun;48(9):1269-82. doi: 10.1016/j.ejca.2011.07.010. Epub 2011 Aug 31.
Although there is consent concerning a higher risk for colorectal cancer (CRC) amongst patients with type 2 diabetes mellitus (T2DM), there remains uncertainty regarding potential sex differences in the strength of this association. We reviewed and summarised epidemiological studies assessing the sex-specific association of T2DM with the risk for CRC. All relevant studies published until 14th February 2011 were identified by a systematic search of MEDLINE, EMBASE, BIOSIS Previews and ISI Web of Knowledge databases and cross-referencing. We included observational studies that reported relative risk (RR) or odds ratio (OR) estimates with 95% confidence intervals (CIs) for the association between T2DM and CRC. Two authors independently extracted data and assessed study quality of each study in a standardised manner. Study-specific estimates were pooled for both sexes separately using random-effects models. A total of 29 eligible studies were used for meta-analysis. Overall estimates of relative risk (RR) were very similar amongst men (RR=1.29; 95%-confidence interval (CI): 1.19-1.140) and women (RR=1.34; 95%-CI: 1.22-1.47). In both men and women, risk estimates from case-control studies were slightly higher than those from cohort studies. Overall, T2DM is associated with a moderate increase in CRC risk in both men and women.
尽管有研究表明 2 型糖尿病(T2DM)患者罹患结直肠癌(CRC)的风险较高,但对于这种关联的潜在性别差异,仍存在不确定性。我们回顾并总结了评估 T2DM 与 CRC 风险之间的特定性别关联的流行病学研究。通过系统搜索 MEDLINE、EMBASE、BIOSIS Previews 和 ISI Web of Knowledge 数据库以及交叉引用,确定了截至 2011 年 2 月 14 日的所有相关研究。我们纳入了报告 T2DM 与 CRC 之间关联的相对风险(RR)或比值比(OR)估计值及其 95%置信区间(CI)的观察性研究。两位作者以标准化的方式独立提取数据并评估了每项研究的质量。使用随机效应模型分别对男性和女性进行了研究特异性估计值的汇总。共有 29 项符合条件的研究用于荟萃分析。男性(RR=1.29;95%-CI:1.19-1.140)和女性(RR=1.34;95%-CI:1.22-1.47)的相对风险(RR)总体估计值非常相似。在男性和女性中,来自病例对照研究的风险估计值略高于来自队列研究的风险估计值。总体而言,T2DM 与男性和女性 CRC 风险的中度增加相关。