Xiao Wenxuan, Huang Jinglong, Zhao Chuanyi, Ding Lu, Wang Xuan, Wu Bian
Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Oncol. 2022 Apr 7;12:737330. doi: 10.3389/fonc.2022.737330. eCollection 2022.
Diabetes is associated with an increased risk of colon cancer (CC). Epidemiologic studies previously reported a higher risk for right-sided colon cancer (RCC) compare to left-sided colon cancer (LCC), although data are conflicting. We performed a meta-analysis to investigate this issue.
We systematically searched the PubMed, EMBASE, Web of Science and Cochrane Library database for prospective cohort studies published up to June 2021. Studies were included if they reported site-specific estimates of the relative risk (RR) between diabetes and the risks of RCC and LCC. Random effects meta-analyses with inverse variance weighting were used to estimate the pooled site-specific RRs and the RCC-to-LCC ratio of RRs (RRRs).
Data from 10 prospective cohort studies, representing 1,642,823 individuals (mainly white) and 17,624 CC patients, were included in the analysis. Diabetes was associated with an increased risk of both RCC (RR =1.35, 95% CI = 1.24-1.47) and LCC (RR = 1.18, 95% CI = 1.08-1.28). After adjusting for major risk factors, individuals with diabetes had a greater risk for RCC than for LCC (RRR = 1.13, 95% CI = 1.02-1.26), with no significant heterogeneity between studies (I = 0%).
This meta-analysis indicates that diabetes is associated with a higher risk for RCC than for LCC. Our findings suggest that colonoscopic surveillance in diabetic patients with careful examination of the right colon is warranted.
糖尿病与结肠癌（CC）风险增加相关。既往流行病学研究报告称，与左侧结肠癌（LCC）相比，右侧结肠癌（RCC）风险更高，尽管数据存在冲突。我们进行了一项荟萃分析以研究此问题。
我们系统检索了截至2021年6月发表的PubMed、EMBASE、科学网和考克兰图书馆数据库中的前瞻性队列研究。如果研究报告了糖尿病与RCC和LCC风险之间特定部位的相对风险（RR）估计值，则纳入研究。采用随机效应荟萃分析和逆方差加权法来估计汇总的特定部位RRs以及RRs的RCC与LCC比值（RRRs）。
分析纳入了10项前瞻性队列研究的数据，涉及1,642,823人（主要为白人）和17,624例CC患者。糖尿病与RCC（RR = 1.35，95%CI = 1.24 - 1.47）和LCC（RR = 1.18，95%CI = 1.08 - 1.28）风险增加均相关。在调整主要危险因素后，糖尿病患者患RCC的风险高于LCC（RRR = 1.13，95%CI = 1.02 - 1.26），研究间无显著异质性（I² = 0%）。
这项荟萃分析表明，糖尿病与RCC风险高于LCC相关。我们的研究结果提示，对糖尿病患者进行结肠镜检查并仔细检查右半结肠是必要的。
