Diabetes mellitus and subsite-specific colorectal cancer risks in the Iowa Women's Health Study

Paul John Limburg, Kristin E. Anderson, Trista W. Johnson, David R. Jacobs, DeAnn Lazovich, Ching Ping Hong, Kristin K. Nicodemus, Aaron R. Folsom

Research output: Contribution to journalArticle

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Abstract

Objective: Controversy remains regarding the association between type 2 diabetes mellitus (DM) and colorectal cancer (CRC) risk. To clarify and extend the existing data, we prospectively evaluated the association between self-reported type 2 DM (onset at >30 years of age) and incident CRC, overall and by anatomic subsite, among postmenopausal women in the Iowa Women's Health Study (n = 35,230). Methods: After 14 years of follow-up, a total of 870 incident CRC cases were identified through annual linkage to the Iowa Cancer Registry. DM was analyzed as reported at baseline and as a time-dependent variable using information obtained during follow-up. CRC risks were estimated using Cox proportional hazards regression models. Results: After adjusting for age, body mass index and other potential confounding variables, the relative risk (RR) for women with DM versus women without DM was modestly increased at 1.4 [95% confidence interval (95% CI), 1.1-1.8]. By anatomic subsite, the RR for proximal colon cancer was statistically significantly increased (RR, 1.9; 95% CI, 1.3-2.6), whereas the RRs for distal colon (RR, 1.1; 95% CI, 0.6-1.8) and rectal cancer (RR, 0.8; 95% CI, 0.4-1.6) were not statistically different from unity. Analyses that included DM ascertained at baseline and follow-up yielded similar results. Conclusion: In this large, prospective study of postmenopausal women, the association between DM and incident CRC was found to be subsite specific. If confirmed by others, this finding implies that CRC prevention strategies among type 2 DM patients should include examination of the proximal colon.

Original languageEnglish (US)
Pages (from-to)133-137
Number of pages5
JournalCancer Epidemiology Biomarkers and Prevention
Volume14
Issue number1
StatePublished - Jan 2005

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Women's Health
Colorectal Neoplasms
Diabetes Mellitus
Confidence Intervals
Type 2 Diabetes Mellitus
Colon
Confounding Factors (Epidemiology)
Rectal Neoplasms
Proportional Hazards Models
Colonic Neoplasms
Registries
Body Mass Index
Prospective Studies
Neoplasms

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Limburg, P. J., Anderson, K. E., Johnson, T. W., Jacobs, D. R., Lazovich, D., Hong, C. P., ... Folsom, A. R. (2005). Diabetes mellitus and subsite-specific colorectal cancer risks in the Iowa Women's Health Study. Cancer Epidemiology Biomarkers and Prevention, 14(1), 133-137.

Diabetes mellitus and subsite-specific colorectal cancer risks in the Iowa Women's Health Study. / Limburg, Paul John; Anderson, Kristin E.; Johnson, Trista W.; Jacobs, David R.; Lazovich, DeAnn; Hong, Ching Ping; Nicodemus, Kristin K.; Folsom, Aaron R.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 14, No. 1, 01.2005, p. 133-137.

Research output: Contribution to journalArticle

Limburg, PJ, Anderson, KE, Johnson, TW, Jacobs, DR, Lazovich, D, Hong, CP, Nicodemus, KK & Folsom, AR 2005, 'Diabetes mellitus and subsite-specific colorectal cancer risks in the Iowa Women's Health Study', Cancer Epidemiology Biomarkers and Prevention, vol. 14, no. 1, pp. 133-137.
Limburg, Paul John ; Anderson, Kristin E. ; Johnson, Trista W. ; Jacobs, David R. ; Lazovich, DeAnn ; Hong, Ching Ping ; Nicodemus, Kristin K. ; Folsom, Aaron R. / Diabetes mellitus and subsite-specific colorectal cancer risks in the Iowa Women's Health Study. In: Cancer Epidemiology Biomarkers and Prevention. 2005 ; Vol. 14, No. 1. pp. 133-137.
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abstract = "Objective: Controversy remains regarding the association between type 2 diabetes mellitus (DM) and colorectal cancer (CRC) risk. To clarify and extend the existing data, we prospectively evaluated the association between self-reported type 2 DM (onset at >30 years of age) and incident CRC, overall and by anatomic subsite, among postmenopausal women in the Iowa Women's Health Study (n = 35,230). Methods: After 14 years of follow-up, a total of 870 incident CRC cases were identified through annual linkage to the Iowa Cancer Registry. DM was analyzed as reported at baseline and as a time-dependent variable using information obtained during follow-up. CRC risks were estimated using Cox proportional hazards regression models. Results: After adjusting for age, body mass index and other potential confounding variables, the relative risk (RR) for women with DM versus women without DM was modestly increased at 1.4 [95{\%} confidence interval (95{\%} CI), 1.1-1.8]. By anatomic subsite, the RR for proximal colon cancer was statistically significantly increased (RR, 1.9; 95{\%} CI, 1.3-2.6), whereas the RRs for distal colon (RR, 1.1; 95{\%} CI, 0.6-1.8) and rectal cancer (RR, 0.8; 95{\%} CI, 0.4-1.6) were not statistically different from unity. Analyses that included DM ascertained at baseline and follow-up yielded similar results. Conclusion: In this large, prospective study of postmenopausal women, the association between DM and incident CRC was found to be subsite specific. If confirmed by others, this finding implies that CRC prevention strategies among type 2 DM patients should include examination of the proximal colon.",
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N2 - Objective: Controversy remains regarding the association between type 2 diabetes mellitus (DM) and colorectal cancer (CRC) risk. To clarify and extend the existing data, we prospectively evaluated the association between self-reported type 2 DM (onset at >30 years of age) and incident CRC, overall and by anatomic subsite, among postmenopausal women in the Iowa Women's Health Study (n = 35,230). Methods: After 14 years of follow-up, a total of 870 incident CRC cases were identified through annual linkage to the Iowa Cancer Registry. DM was analyzed as reported at baseline and as a time-dependent variable using information obtained during follow-up. CRC risks were estimated using Cox proportional hazards regression models. Results: After adjusting for age, body mass index and other potential confounding variables, the relative risk (RR) for women with DM versus women without DM was modestly increased at 1.4 [95% confidence interval (95% CI), 1.1-1.8]. By anatomic subsite, the RR for proximal colon cancer was statistically significantly increased (RR, 1.9; 95% CI, 1.3-2.6), whereas the RRs for distal colon (RR, 1.1; 95% CI, 0.6-1.8) and rectal cancer (RR, 0.8; 95% CI, 0.4-1.6) were not statistically different from unity. Analyses that included DM ascertained at baseline and follow-up yielded similar results. Conclusion: In this large, prospective study of postmenopausal women, the association between DM and incident CRC was found to be subsite specific. If confirmed by others, this finding implies that CRC prevention strategies among type 2 DM patients should include examination of the proximal colon.

AB - Objective: Controversy remains regarding the association between type 2 diabetes mellitus (DM) and colorectal cancer (CRC) risk. To clarify and extend the existing data, we prospectively evaluated the association between self-reported type 2 DM (onset at >30 years of age) and incident CRC, overall and by anatomic subsite, among postmenopausal women in the Iowa Women's Health Study (n = 35,230). Methods: After 14 years of follow-up, a total of 870 incident CRC cases were identified through annual linkage to the Iowa Cancer Registry. DM was analyzed as reported at baseline and as a time-dependent variable using information obtained during follow-up. CRC risks were estimated using Cox proportional hazards regression models. Results: After adjusting for age, body mass index and other potential confounding variables, the relative risk (RR) for women with DM versus women without DM was modestly increased at 1.4 [95% confidence interval (95% CI), 1.1-1.8]. By anatomic subsite, the RR for proximal colon cancer was statistically significantly increased (RR, 1.9; 95% CI, 1.3-2.6), whereas the RRs for distal colon (RR, 1.1; 95% CI, 0.6-1.8) and rectal cancer (RR, 0.8; 95% CI, 0.4-1.6) were not statistically different from unity. Analyses that included DM ascertained at baseline and follow-up yielded similar results. Conclusion: In this large, prospective study of postmenopausal women, the association between DM and incident CRC was found to be subsite specific. If confirmed by others, this finding implies that CRC prevention strategies among type 2 DM patients should include examination of the proximal colon.

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