Abstract
Colorectal cancer remains a major health burden worldwide and is closely related to type 2 diabetes. This study aimed to develop and validate a colorectal cancer risk prediction model to identify high-risk individuals with type 2 diabetes. Records of 930 patients with type 2 diabetes were reviewed and data were collected from 1 November 2013 to 31 December 2019. Clinical and demographic parameters were analyzed using univariable and multivariable logistic regression analysis. The nomogram to assess the risk of colorectal cancer was constructed and validated by bootstrap resampling. Predictors in the prediction nomogram included age, sex, other blood-glucose-lowering drugs and thiazolidinediones. The nomogram demonstrated moderate discrimination in estimating the risk of colorectal cancer, with Hosmer–Lemeshow test P = 0.837, an unadjusted C-index of 0.713 (95% CI 0.670–0.757) and a bootstrap-corrected C index of 0.708. In addition, the decision curve analysis demonstrated that the nomogram would be clinically useful. We have developed a nomogram that can predict the risk of colorectal cancer in patients with type 2 diabetes. The nomogram showed favorable calibration and discrimination values, which may help clinicians in making recommendations about colorectal cancer screening for patients with type 2 diabetes.
Highlights
Colorectal cancer remains a major health burden worldwide and is closely related to type 2 diabetes
Diabetes may influence the neoplastic process by several mechanisms, including hyperinsulinemia, hyperglycemia, or chronic inflammation[13]
This study aimed to identify a combination of variables that would enable a highly accurate prediction of colorectal cancer in patients with type 2 diabetes
Summary
Colorectal cancer remains a major health burden worldwide and is closely related to type 2 diabetes. We have developed a nomogram that can predict the risk of colorectal cancer in patients with type 2 diabetes. Despite the rapid development of diagnostic and treatment methods, the 5-year survival rate for colorectal cancer is ≈ 50% overall[3], this rate for colorectal cancer diagnosed in the early stages is > 90%4. Current screening methods for colorectal cancer mainly include flexible sigmoidoscopy, colonoscopy, fecal occult blood testing, double-contrast barium enema, stool DNA testing, and computed tomographic colonography[8]. These examinations are invasive or time-consuming or expensive, and it is not feasible to screen the general population for colorectal cancer. Targeted screening for colorectal cancer (e.g., using flexible sigmoidoscopy) may be feasible if diabetic individuals at the highest risk for colorectal cancer could be identified
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