Diabetes mellitus and risk of colorectal cancer: A meta-analysis

被引:765
作者
Larsson, SC [1 ]
Orsini, N [1 ]
Wolk, A [1 ]
机构
[1] Natl Inst Environm Med, Div Nutr Epidemiol, Karolinska Inst, SE-17177 Stockholm, Sweden
来源
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2005年 / 97卷 / 22期
关键词
D O I
10.1093/jnci/dji375
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Diabetes has been associated with an increased risk of colorectal cancer in most, but not all, studies. Findings have also been inconclusive with regard to sex and subsite in the colorectum. To resolve these inconsistencies, we conducted a meta-analysis of published data on the association between diabetes and the incidence and mortality of colorectal cancer. Methods: We identified studies by a literature search of Medline from January 1, 1966, through July 31, 2005, and by searching the reference lists of pertinent articles. Summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated with a random-effects model. All statistical tests were two-sided. Results: Analysis of 15 studies (six case-control and nine cohort studies), including 2593935 participants, found that diabetes was associated with an increased risk of colorectal cancer, compared with no diabetes (summary RR of colorectal cancer incidence = 1.30, 95% CI = 1.20 to 1.40), without heterogeneity between studies (P-heterogeneity = .21). These results were consistent between case-control and cohort studies and between studies conducted in the United States and in Europe. The association between diabetes and colorectal cancer incidence did not differ statistically significantly by sex (summary RR among women = 1.33, 95% CI = 1.23 to 1.44; summary RR among men = 1.29, 95% CI = 1.15 to 1.44; P-heterogeneity = .26) or by cancer subsite (summary RR for colon = 1.43, 95% CI = 1.28 to 1.60; summary RR for rectum = 1.33, 95% CI = 1.14 to 1.54; P-heterogeneity = .42). Diabetes was positively associated with colorectal cancer mortality (summary RR = 1.26, 95% CI = 1.05 to 1.50), but there was evidence for heterogeneity between studies (Pheterogeneity = .04). Conclusions: Our findings strongly support a relationship between diabetes and increased risk of colon and rectal cancer in both women and men.
引用
收藏
页码:1679 / 1687
页数:9
相关论文
共 56 条
[1]   CANCER RISK IN PATIENTS WITH DIABETES-MELLITUS [J].
ADAMI, HO ;
MCLAUGHLIN, J ;
EKBOM, A ;
BERNE, C ;
SILVERMAN, D ;
HACKER, D ;
PERSSON, I .
CANCER CAUSES & CONTROL, 1991, 2 (05) :307-314
[2]   Projection of diabetes burden through 2050 - Impact of changing demography and disease prevalence in the US [J].
Boyle, JP ;
Honeycutt, AA ;
Narayan, KMV ;
Hoerger, TJ ;
Geiss, LS ;
Chen, H ;
Thompson, TJ .
DIABETES CARE, 2001, 24 (11) :1936-1940
[3]   Diabetes mellitus as a predictor of cancer mortality in a large cohort of US adults [J].
Coughlin, SS ;
Calle, EE ;
Teras, LR ;
Petrelli, J ;
Thun, MJ .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 2004, 159 (12) :1160-1167
[4]   The role of bile acids in carcinogenesis [J].
Debruyne, PR ;
Bruyneel, EA ;
Li, XD ;
Zimber, A ;
Gespach, C ;
Mareel, MM .
MUTATION RESEARCH-FUNDAMENTAL AND MOLECULAR MECHANISMS OF MUTAGENESIS, 2001, 480 :359-369
[5]   METAANALYSIS IN CLINICAL-TRIALS [J].
DERSIMONIAN, R ;
LAIRD, N .
CONTROLLED CLINICAL TRIALS, 1986, 7 (03) :177-188
[6]   Bias in meta-analysis detected by a simple, graphical test [J].
Egger, M ;
Smith, GD ;
Schneider, M ;
Minder, C .
BMJ-BRITISH MEDICAL JOURNAL, 1997, 315 (7109) :629-634
[7]  
Egger M., 2001, Systematic Reviews in Health Care, V2nd ed.
[8]   The evolving diabetes burden in the United States [J].
Engelgau, MM ;
Geiss, LS ;
Saaddine, JB ;
Boyle, JP ;
Benjamin, SM ;
Gregg, EW ;
Tierney, EF ;
Rios-Burrows, N ;
Mokdad, AH ;
Ford, ES ;
Imperatore, G ;
Narayan, KMV .
ANNALS OF INTERNAL MEDICINE, 2004, 140 (11) :945-950
[9]   Dietary patterns, meat intake, and the risk of type 2 diabetes in women [J].
Fung, TT ;
Schulze, M ;
Manson, JE ;
Willett, WC ;
Hu, FB .
ARCHIVES OF INTERNAL MEDICINE, 2004, 164 (20) :2235-2240
[10]  
Giovannucci E, 2000, CANCER EPIDEM BIOMAR, V9, P345