Prospective study of adult onset diabetes mellitus (type 2) and risk of colorectal cancer in women
Prospective study of adult onset diabetes mellitus (type 2) and risk of colorectal cancer in women
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DOI：
10.1093/jnci/91.6.542
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发表时间：
1999-03-17
影响因子：
10.3
通讯作者：
Giovannucci, E
中科院分区：
文献类型：
--
作者：
Hu, FB;Manson, JE;Giovannucci, E
背景资料：2型（非胰岛素依赖型）糖尿病和结肠癌的生活方式和环境风险因素的显著相似性导致了糖尿病可能增加这种癌症风险的假设。我们前瞻性地研究了118403名年龄在30岁至55岁之间的妇女中糖尿病与结直肠癌风险之间的关系，这些妇女在1976年基线时没有被诊断为癌症。方法：这些妇女参加了护士健康研究，在基线和随访期间使用两年一次的问卷调查评估糖尿病史。自我报告的糖尿病通过从症状和治疗的补充问卷中获得的信息进行验证，并通过参与者样本的医疗记录审查进行确认。结直肠癌的发病病例通过病历审查确定。所有报告的P值均为双侧。结果：在18年的随访（2001061人年）中，我们记录了892例新的结直肠癌病例。校正年龄、体重指数后（体重kg/身高m2）、体力活动和其他协变量，相对危险度（RR）为1.43（95%置信区间[CI] = 1.10-1.87; P =.009），结直肠癌，1.49（95% CI = 1.09-2.06; P =.01）结肠癌，1.11（95% CI = 0.56-2.21; P = 0.76）直肠癌，1.56（95% CI = 1.07-2.28; P = 0.02）晚期结直肠癌，2.39（95% CI = 1.46-3.92; P = 0.0005）致命性结直肠癌。结论：我们的数据支持糖尿病与女性结直肠癌风险增加相关的假设。
Background: The remarkable similarity of lifestyle and environmental risk factors for type 2 (non-insulin-dependent) diabetes mellitus and colon cancer has led to the hypothesis that diabetes may increase the risk of this cancer. We prospectively examined the relationship between diabetes and risk of colorectal cancer in a cohort of 118403 women aged 30 through 55 years who were without previously diagnosed cancer at baseline in 1976, Methods: The women, who were enrolled in the Nurses' Health Study, were assessed for history of diabetes at baseline and during follow-up by use of biennial questionnaires. Self-reported diabetes was validated by information obtained from a supplemental questionnaire on symptoms and treatment and was confirmed by medical record review in a sample of the participants. Incident cases of colorectal cancer were ascertained through medical record review. All reported P values are two-sided. Results: During 18 years of follow-up (2001061 person-years), we documented 892 new cases of colorectal cancer. After adjustment for age, body mass index (weight in kg/height in m(2)), physical activity, and other covariates, relative risks (RRs) were 1.43 (95% confidence interval [CI] = 1.10-1.87; P =.009) for colorectal cancer, 1.49 (95% CI = 1.09-2.06; P =.01) for colon cancer, 1.11 (95% CI = 0.56-2.21; P =.76) for rectal cancer, 1.56 (95% CI = 1.07-2.28; P =.02) for advanced colorectal cancer, and 2.39 (95% CI = 1.46-3.92; P =.0005) for fatal colorectal cancer. Conclusion: Our data provide support for the hypothesis that diabetes is associated with an increased risk of colorectal cancer in women.