Significantly higher rates of multiple and proximally located adenomas among patients with diabetes mellitus: A cross-sectional population-based study.

BACKGROUND

Diabetes mellitus (DM) is associated with a greater risk for colorectal cancer (CRC).

OBJECTIVE

The objective of this article is to examine the endoscopic phenotype and histopathology of colorectal polyps in patients with vs without DM.

METHODS

We conducted a cross-sectional study of patients who underwent colonoscopy at our university hospital and who completed a questionnaire. We collected endoscopy and histopathology data regarding colorectal adenomas and serrated polyps. Cox regression analyses were used to estimate adjusted prevalence ratios (PRs).

RESULTS

We examined a total of 3654 patients (mean age (SD): 62 (12) years, 47% males). Of them, 360 (9.9%) had DM. Overall, the prevalence of colorectal adenomas (42% vs 32%,  < 0.01), multiple (≥3) adenomas (12% vs 7%,  = 0.01) and proximal adenomas (30% vs 19%,  < 0.01) was higher in patients with vs without DM. Multivariable analysis showed that the prevalence of adenomas (PR 1.17, 95% CI; 1.02-1.34), multiple (PR 1.37, 95% CI; 1.00-1.86) and proximal (PR 1.37, 95% CI; 1.16-1.62) adenomas was higher in patients with vs without DM, especially in men.

CONCLUSION

Patients with DM harbor more frequently multiple and proximal adenomas than those without DM. Close colonoscopic surveillance of DM patients is important to maximize the effectiveness of colonoscopic CRC prevention.