Abstract
Previous cohort studies have demonstrated a positive association between diabetes mellitus (DM) and colorectal cancer (CRC). However, there are few comparisons between DM groups categorized by fasting glucose level. This study examined associations between diabetes as defined by fasting glucose level and self-reported history of DM and CRC risk among Korean adults. Data from the Korean Multi-center Cancer Cohort between 1993 and 2005 were analyzed. The study population comprised 14,570 participants aged 20 years or older. Participants were followed until December 31, 2012 (median follow-up: 11.9 years). Among participants with high fasting glucose (≥126mg/dL), the risk of developing CRC was significantly higher (HR: 1.51 [1.02–2.25]) than among participants with low fasting glucose (<126mg/dL). Risk was not significantly higher among participants with self-reported history of DM (HR: 1.34 [0.78–2.31]). When both fasting glucose and history of DM were considered together, the risk of CRC among participants with both high fasting glucose and history of DM was 54% (HR: 1.54 [0.97–2.43]), and the risk of CRC among participants with high fasting glucose and no history of DM was 50% (HR: 1.50 [0.73–3.05]). When the first 5 years of follow-up were excluded, among participants with high fasting glucose, the risk of developing CRC was significantly higher (HR: 1.61 [1.02–2.56]) than among participants with low fasting glucose. Risk of CRC was also significantly higher among participants with high fasting glucose and no history of DM (HR: 1.69 [1.01–2.84]). High fasting glucose and self-reported history of DM were associated with increased risk of CRC in this Korean population.
Highlights
IntroductionThe age-standardized incidence rate per 100,000 population for colorectal cancer in 2013 was 46.9 for men and 25.5 for women
We excluded participants who had no information on age at cohort recruitment (1,182 men and 1,792 women), whose fasting glucose level information was incomplete or Fasting glucose and colorectal cancer risk who had no information about history of diabetes mellitus (1,007 men and 1,575 women), who were aged 20 years or younger (156 men and 334 women), who had a prior diagnosis of colorectal cancer (6 men and 13 women), or who were censored within one month from the baseline survey (1 man)
The effect of hazard ratio of colorectal cancer according to the fasting glucose level is toward the null. Both fasting glucose level and self-reported history of diabetes mellitus were associated with increased colorectal cancer risk in the Korean Multi-center Cancer Cohort
Summary
The age-standardized incidence rate per 100,000 population for colorectal cancer in 2013 was 46.9 for men and 25.5 for women. [3] According to the Korean Statistics Office, the age-standardized mortality rate for diabetes mellitus was 12.8 per 100,000 population in 2015, which was lower than the previous year. [4] Among individuals aged 30 years or older, the age-standardized prevalence of diabetes mellitus was close to 9% for the decade between 2000 and 2010 and increased to 10.2% in 2014. Among all Koreans aged 30 years or older, the prevalence of diabetes mellitus was 9.5% in 2015; among men prevalence was 11.0% and among women it was 8.0%. The treatment rate (the proportion of people treated with glucose-lowering medications or insulin injections) was about 60% and was higher among women and older patients
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