Abstract
Epidemiological and experimental studies suggest that type 2 DM is associated with increased risk for Colorectal Cancer (CRC). Hyperinsulinemia, either endogenous or exogenous, has been proposed to increase CRC risk. High levels of insulin induce colonic cell proliferation and reduce apoptosis by increasing the bioavailability of IGF-1. Although a large cohort study found that insulin use was not associated with a substantially increased risk of CRC, more recently it has been suggested that exogenous insulin was associated with increased risk of CRC and colorectal adenomas among patients with type 2 diabetes on insulin therapy compared with noninsulin users, On the other hand, a significant reduction of colorectal cancer risk was observed in insulin-treated patients after adjusting for confounders.
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