Prospective study reveals associations between colorectal cancer and type 2 diabetes mellitus or insulin use in men

Peter T. Campbell, Anusila Deka, Eric J. Jacobs, Christina C. Newton, Janet S. Hildebrand, Marjorie L. McCullough, Paul John Limburg, Susan M. Gapstur

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Background & Aims Type 2 diabetes mellitus (DM) is associated with an increased risk of colorectal cancer (CRC); it is not clear if this association varies by sex or other factors. Insulin use might also be associated with CRC risk. We investigated associations of type 2 DM and insulin use with CRC risk. Methods The Cancer Prevention Study II Nutrition Cohort is a prospective study of cancer incidence. In 1992 or 1993, adult participants (n = 184,194) completed a detailed, self-administered questionnaire. Follow-up questionnaires were sent in 1997 and every 2 years thereafter. Cox proportional hazards regression analysis was used to calculate relative risks (RR) and 95% confidence intervals (CI), adjusting for covariates. Results After exclusions, 73,312 men and 81,663 women remained in the final analytic cohort; 1567 men (227 with type 2 DM) and 1242 women (108 with type 2 DM) were diagnosed with colon or rectal cancer by 2007. Among men, type 2 DM was associated with increased risk of incident CRC compared to not having type 2 DM (RR: 1.24; 95% CI: 1.08-1.44); risk was higher for participants with type 2 DM using insulin (RR: 1.36; 95% CI: 1.05-1.78), and participants with type 2 DM not using insulin (RR: 1.22, 95% CI: 1.04-1.45). Among women, type 2 DM and insulin use were not associated with risk of incident CRC (RR: 1.01; 95% CI: 0.82-1.23 and RR: 0.95; 95% CI: 0.64-1.41, respectively). Conclusions There is a modest association between type 2 DM and CRC among men, but not women. Insulin use is not associated with a substantially increased risk of CRC.

Original languageEnglish (US)
Pages (from-to)1138-1146
Number of pages9
JournalGastroenterology
Volume139
Issue number4
DOIs
StatePublished - 2010

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Type 2 Diabetes Mellitus
Colorectal Neoplasms
Prospective Studies
Insulin
Confidence Intervals
Rectal Neoplasms
Colonic Neoplasms
Neoplasms
Regression Analysis

Keywords

  • Carcinogenesis
  • Cigarette Smoking
  • Colon Cancer
  • Family History

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

Cite this

Campbell, P. T., Deka, A., Jacobs, E. J., Newton, C. C., Hildebrand, J. S., McCullough, M. L., ... Gapstur, S. M. (2010). Prospective study reveals associations between colorectal cancer and type 2 diabetes mellitus or insulin use in men. Gastroenterology, 139(4), 1138-1146. https://doi.org/10.1053/j.gastro.2010.06.072

Prospective study reveals associations between colorectal cancer and type 2 diabetes mellitus or insulin use in men. / Campbell, Peter T.; Deka, Anusila; Jacobs, Eric J.; Newton, Christina C.; Hildebrand, Janet S.; McCullough, Marjorie L.; Limburg, Paul John; Gapstur, Susan M.

In: Gastroenterology, Vol. 139, No. 4, 2010, p. 1138-1146.

Research output: Contribution to journalArticle

Campbell, PT, Deka, A, Jacobs, EJ, Newton, CC, Hildebrand, JS, McCullough, ML, Limburg, PJ & Gapstur, SM 2010, 'Prospective study reveals associations between colorectal cancer and type 2 diabetes mellitus or insulin use in men', Gastroenterology, vol. 139, no. 4, pp. 1138-1146. https://doi.org/10.1053/j.gastro.2010.06.072
Campbell, Peter T. ; Deka, Anusila ; Jacobs, Eric J. ; Newton, Christina C. ; Hildebrand, Janet S. ; McCullough, Marjorie L. ; Limburg, Paul John ; Gapstur, Susan M. / Prospective study reveals associations between colorectal cancer and type 2 diabetes mellitus or insulin use in men. In: Gastroenterology. 2010 ; Vol. 139, No. 4. pp. 1138-1146.
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abstract = "Background & Aims Type 2 diabetes mellitus (DM) is associated with an increased risk of colorectal cancer (CRC); it is not clear if this association varies by sex or other factors. Insulin use might also be associated with CRC risk. We investigated associations of type 2 DM and insulin use with CRC risk. Methods The Cancer Prevention Study II Nutrition Cohort is a prospective study of cancer incidence. In 1992 or 1993, adult participants (n = 184,194) completed a detailed, self-administered questionnaire. Follow-up questionnaires were sent in 1997 and every 2 years thereafter. Cox proportional hazards regression analysis was used to calculate relative risks (RR) and 95{\%} confidence intervals (CI), adjusting for covariates. Results After exclusions, 73,312 men and 81,663 women remained in the final analytic cohort; 1567 men (227 with type 2 DM) and 1242 women (108 with type 2 DM) were diagnosed with colon or rectal cancer by 2007. Among men, type 2 DM was associated with increased risk of incident CRC compared to not having type 2 DM (RR: 1.24; 95{\%} CI: 1.08-1.44); risk was higher for participants with type 2 DM using insulin (RR: 1.36; 95{\%} CI: 1.05-1.78), and participants with type 2 DM not using insulin (RR: 1.22, 95{\%} CI: 1.04-1.45). Among women, type 2 DM and insulin use were not associated with risk of incident CRC (RR: 1.01; 95{\%} CI: 0.82-1.23 and RR: 0.95; 95{\%} CI: 0.64-1.41, respectively). Conclusions There is a modest association between type 2 DM and CRC among men, but not women. Insulin use is not associated with a substantially increased risk of CRC.",
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T1 - Prospective study reveals associations between colorectal cancer and type 2 diabetes mellitus or insulin use in men

AU - Campbell, Peter T.

AU - Deka, Anusila

AU - Jacobs, Eric J.

AU - Newton, Christina C.

AU - Hildebrand, Janet S.

AU - McCullough, Marjorie L.

AU - Limburg, Paul John

AU - Gapstur, Susan M.

PY - 2010

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N2 - Background & Aims Type 2 diabetes mellitus (DM) is associated with an increased risk of colorectal cancer (CRC); it is not clear if this association varies by sex or other factors. Insulin use might also be associated with CRC risk. We investigated associations of type 2 DM and insulin use with CRC risk. Methods The Cancer Prevention Study II Nutrition Cohort is a prospective study of cancer incidence. In 1992 or 1993, adult participants (n = 184,194) completed a detailed, self-administered questionnaire. Follow-up questionnaires were sent in 1997 and every 2 years thereafter. Cox proportional hazards regression analysis was used to calculate relative risks (RR) and 95% confidence intervals (CI), adjusting for covariates. Results After exclusions, 73,312 men and 81,663 women remained in the final analytic cohort; 1567 men (227 with type 2 DM) and 1242 women (108 with type 2 DM) were diagnosed with colon or rectal cancer by 2007. Among men, type 2 DM was associated with increased risk of incident CRC compared to not having type 2 DM (RR: 1.24; 95% CI: 1.08-1.44); risk was higher for participants with type 2 DM using insulin (RR: 1.36; 95% CI: 1.05-1.78), and participants with type 2 DM not using insulin (RR: 1.22, 95% CI: 1.04-1.45). Among women, type 2 DM and insulin use were not associated with risk of incident CRC (RR: 1.01; 95% CI: 0.82-1.23 and RR: 0.95; 95% CI: 0.64-1.41, respectively). Conclusions There is a modest association between type 2 DM and CRC among men, but not women. Insulin use is not associated with a substantially increased risk of CRC.

AB - Background & Aims Type 2 diabetes mellitus (DM) is associated with an increased risk of colorectal cancer (CRC); it is not clear if this association varies by sex or other factors. Insulin use might also be associated with CRC risk. We investigated associations of type 2 DM and insulin use with CRC risk. Methods The Cancer Prevention Study II Nutrition Cohort is a prospective study of cancer incidence. In 1992 or 1993, adult participants (n = 184,194) completed a detailed, self-administered questionnaire. Follow-up questionnaires were sent in 1997 and every 2 years thereafter. Cox proportional hazards regression analysis was used to calculate relative risks (RR) and 95% confidence intervals (CI), adjusting for covariates. Results After exclusions, 73,312 men and 81,663 women remained in the final analytic cohort; 1567 men (227 with type 2 DM) and 1242 women (108 with type 2 DM) were diagnosed with colon or rectal cancer by 2007. Among men, type 2 DM was associated with increased risk of incident CRC compared to not having type 2 DM (RR: 1.24; 95% CI: 1.08-1.44); risk was higher for participants with type 2 DM using insulin (RR: 1.36; 95% CI: 1.05-1.78), and participants with type 2 DM not using insulin (RR: 1.22, 95% CI: 1.04-1.45). Among women, type 2 DM and insulin use were not associated with risk of incident CRC (RR: 1.01; 95% CI: 0.82-1.23 and RR: 0.95; 95% CI: 0.64-1.41, respectively). Conclusions There is a modest association between type 2 DM and CRC among men, but not women. Insulin use is not associated with a substantially increased risk of CRC.

KW - Carcinogenesis

KW - Cigarette Smoking

KW - Colon Cancer

KW - Family History

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