Dept. of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands.
GROW - School for Oncology and Developmental Biology, Maastricht, The Netherlands.
Sci Rep. 2017 Apr 24;7:46527. doi: 10.1038/srep46527.
Type 2 diabetes mellitus (T2DM) is associated with greater risk for colorectal cancer (CRC). The age of onset of T2DM is decreasing worldwide. An increased CRC risk in young T2DM patients could be relevant for the age at which to initiate CRC screening. We report on CRC risk in T2DM patients with attention to age of diagnosis. We used pharmacy data (from 1998 to 2010) from the PHARMO Database Network linked to the Eindhoven Cancer Registry. Multivariable time-dependent Cox regression analyses were conducted to calculate hazard ratios (HR) for developing CRC comparing T2DM with non-T2DM. During 2,599,925 years of follow-up, 394 CRC cases among 41,716 diabetes patients (mean age 64.0 yr, 48% men) and 1,939 CRC cases among 325,054 non-diabetic patients (mean age 51.2 yr, 46% men) were identified. Diabetes was associated with an increased CRC risk in both men and women (HR 1.3, 95% CI 1.2-1.5), particularly in the first 6 months after T2DM diagnosis and pronounced in the proximal colon. This risk was even higher in men younger than 55 years (HR 2.0, 95% CI 1.0-3.8). T2DM was associated with a time-varying and subsite-specific increased CRC risk, which was even higher in men aged <55 years.
2 型糖尿病（T2DM）与结直肠癌（CRC）风险增加相关。T2DM 的发病年龄在全球范围内呈下降趋势。年轻 T2DM 患者 CRC 风险增加可能与开始 CRC 筛查的年龄有关。我们报告了 T2DM 患者的 CRC 风险，并特别关注诊断时的年龄。我们使用了 PHARMO 数据库网络的药房数据（1998 年至 2010 年），并与埃因霍温癌症登记处相关联。使用多变量时依 Cox 回归分析计算比较 T2DM 与非 T2DM 发生 CRC 的风险比（HR）。在 2599925 年的随访期间，在 41716 名糖尿病患者（平均年龄 64.0 岁，48%为男性）中发现了 394 例 CRC 病例，在 325054 名非糖尿病患者（平均年龄 51.2 岁，46%为男性）中发现了 1939 例 CRC 病例。糖尿病与男性和女性的 CRC 风险增加相关（HR 1.3，95%CI 1.2-1.5），尤其是在 T2DM 诊断后的前 6 个月，且在近端结肠中更为明显。在年龄小于 55 岁的男性中，这种风险更高（HR 2.0，95%CI 1.0-3.8）。T2DM 与时间变化和部位特异性的 CRC 风险增加相关，在年龄<55 岁的男性中风险更高。
