Age- and Sex-Specific Risks of Colorectal Cancers in Diabetic Patients
Age- and Sex-Specific Risks of Colorectal Cancers in Diabetic Patients
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DOI：
10.1620/tjem.226.259
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发表时间：
2012-04-01
影响因子：
2.2
通讯作者：
Li, Chung-Yi
中科院分区：
文献类型：
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作者：
Chen, Hua-Fen;Chen, Peter;Li, Chung-Yi
在大多数但不是所有的研究中，糖尿病都被报道会增加结直肠癌的风险。然而，关于特定年龄和性别的发病率和与糖尿病相关的相对风险的数据有限。我们开展了这项基于人群的队列研究，以调查与糖尿病相关的结直肠癌的总体性别和年龄相关风险。从索赔数据集中选择的糖尿病患者(n=615,532)和年龄和性别匹配的对照组(n=614,871)，从2000年到2006年进行了随访。结肠癌和直肠癌的入院率用人年法估计，年龄和性别的特定危险比(HR)用COX回归模型确定。糖尿病患者的结肠癌总发病率为每万人年9.94人，而对照组患者为每万人年7.84人。直肠癌的相应观察值分别为7.16和6.28/万人年。45岁的糖尿病患者发生结肠癌的比率显著较高(1.20-1.45倍)。我们还注意到45岁的糖尿病男性直肠癌的发病率显著较高(1.18倍)，但在糖尿病女性中没有。综上所述，糖尿病可能会显著增加患结直肠癌的风险，尤其是在45岁-的患者中。糖尿病医生在治疗中年糖尿病男性时应该牢记这种关系，并建议这些患者接受定期的结直肠癌筛查。
Diabetes has been reported to increase the risk of colorectal neoplasm in most but not all studies. However, the data on age- and sex-specific incidence rates and relative risks associated with diabetes are limited. We carried out this population-based cohort study to investigate the overall sex- and age-specific risks of colorectal cancer in association with diabetes. Diabetic patients (n = 615,532) and age- and sex-matched control individuals (n = 614,871), selected from the claim datasets, were followed up from 2000 to 2006. The rates of admission due to colon and rectum cancers were estimated using the person-years approach, and the age- and sex-specific hazard ratio (HR) for both the malignancies were determined using the Cox regression model. The overall incidence rate of colon cancer was 9.94 per 10,000 patient-years for the diabetic patients, as opposed to 7.84 per 10,000 patient-years for the control-group patients. The corresponding observation for rectal cancer was 7.16 and 6.28 per 10,000 patient-years. Diabetic patients aged 45 years had significantly high HRs for developing colon cancer (1.20-1.45-fold). We also noted a significantly high HR of rectal cancer in diabetic men (1.18-fold) aged 45 years, but not in diabetic women. In conclusion, diabetes may significantly increase the risk of colorectal cancer, especially in patients aged 45-64 years. Diabetologists should keep this relationship in mind while treating middle-aged diabetic men and should also advise these patients to undergo regular screening tests for colorectal cancer.