Seum Teresa, Hoffmeister Michael, Brenner Hermann
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.
Aliment Pharmacol Ther. 2025 Feb;61(4):675-681. doi: 10.1111/apt.18435. Epub 2024 Dec 16.
Individuals with diabetes and metabolic syndrome have an increased risk of colorectal cancer (CRC), suggesting earlier screening than the average-risk population may be warranted.
To derive risk-adapted starting ages of CRC screening for people with diabetes or metabolic syndrome.
We determined 5-year cumulative risks of CRC at individual ages between 30 and 50 across Europe (overall and individually for Germany, France, the UK and Italy) and North America (the United States and Canada) based on the GLOBOCAN 2022 database. Using risk estimates from meta-analyses (2020-2023), we derived the ages at which individuals with diabetes or metabolic syndrome reach the same CRC risk as the average-risk population at age 50 (aCR) or 45 (aCR).
Individuals with diabetes were estimated to reach aCR at age 47 (95% confidence interval, 45-49) in Europe and 46 (42-49) in North America. For metabolic syndrome, the corresponding ages were 47 (47-48) in Europe and 46 (46-47) in North America. Disparities across countries were minimal, with deviations of up to no more than one year. For screening programmes starting at age 45, corresponding risk-adapted starting ages for people with diabetes or metabolic syndrome were estimated to be 42 (41-44) and 43 (42-43) for Europe and 41 (38-44) and 41 (41-42) for North America, respectively.
People with diabetes or metabolic syndrome reach risk levels comparable to the average risk population three to four years earlier. Our results offer empirical guidance for defining risk-adapted starting ages of CRC screening for these high-risk groups.
糖尿病和代谢综合征患者患结直肠癌（CRC）的风险增加，这表明可能需要比一般风险人群更早进行筛查。
确定针对糖尿病或代谢综合征患者的结直肠癌筛查风险适应性起始年龄。
我们基于GLOBOCAN 2022数据库，确定了欧洲（总体以及德国、法国、英国和意大利分别的情况）和北美（美国和加拿大）30至50岁各年龄段的结直肠癌5年累积风险。利用荟萃分析（2020 - 2023年）的风险估计值，我们得出了糖尿病或代谢综合征患者达到与50岁（aCR）或45岁（aCR）的一般风险人群相同结直肠癌风险时的年龄。
估计欧洲糖尿病患者在47岁（95%置信区间，45 - 49岁）达到aCR，北美为46岁（42 - 49岁）。对于代谢综合征，欧洲相应年龄为47岁（47 - 48岁），北美为46岁（46 - 47岁）。各国之间的差异极小，偏差最多不超过一年。对于从45岁开始的筛查项目，欧洲糖尿病或代谢综合征患者相应的风险适应性起始年龄估计分别为42岁（41 - 44岁）和43岁（42 - 43岁），北美分别为41岁（38 - 44岁）和41岁（41 - 42岁）。
糖尿病或代谢综合征患者比一般风险人群早三到四年达到风险水平。我们的结果为确定这些高危人群的结直肠癌筛查风险适应性起始年龄提供了实证指导。
