Is diabetes mellitus an independent risk factor for colon cancer and rectal cancer?
Is diabetes mellitus an independent risk factor for colon cancer and rectal cancer?
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DOI：
10.1038/ajg.2011.301
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发表时间：
2011-11
影响因子：
9.8
通讯作者：
Buffler, Patricia A.
中科院分区：
文献类型：
--
作者：
Yuhara, Hiroki;Steinmaus, Craig;Cohen, Stephanie E.;Corley, Douglas A.;Tei, Yoshihiro;Buffler, Patricia A.
糖尿病（DM）与结直肠癌（CRC）的风险增加有关。美国胃肠病学学会2008年结肠直肠癌筛查指南建议临床医生注意吸烟和肥胖患者结直肠癌风险的增加，但不强调糖尿病患者结直肠癌风险的增加。为了提供糖尿病与结肠癌（CC）和直肠癌（RC）相关性的最新定量评估，我们对病例对照和队列研究进行了荟萃分析。我们还评估了这种关联是否因性别而异，并评估了潜在的混杂因素，包括肥胖、吸烟和运动。我们通过检索EMBASE和MEDLINE数据库（从建立到2009年12月31日）和检索相关文章的参考书目来确定研究。采用固定效应和随机效应模型计算具有95%置信区间（ci）的总相对危险度（rr）。进行了几个亚组分析以探索潜在的研究异质性和偏倚。DM与CC（总RR 1.38, 95% CI 1.26-1.51, n = 14项研究）和RC（总RR 1.20, 95% CI 1.09-1.31, n = 12项研究）的风险增加相关。当我们将meta分析限制在控制吸烟和肥胖，或吸烟、肥胖和体育锻炼的研究中时，这种关联仍然存在。DM与男性（总RR为1.43,95% CI为1.30-1.57,n = 11项研究）和女性（总RR为1.35,95% CI为1.14-1.53,n = 10项研究）的CC风险增加相关。对于RC，男性糖尿病和癌症风险之间存在显著关联（总RR为1.22,95% CI为1.07-1.40;n = 8项研究），但女性没有（总RR为1.09,95% CI为0.99-1.19;n = 8项研究）。这些数据表明糖尿病是结肠癌和直肠癌的独立危险因素。尽管这些发现是基于观察性流行病学研究，由于诊断偏倚和混淆存在固有局限性，但亚组分析证实了我们的研究结果在研究类型和人群中的一致性。这些信息可以为风险模型和专业协会CRC筛查指南提供信息。
Diabetes mellitus (DM) has been associated with an increased risk of colorectal cancer (CRC). The American College of Gastroenterology Guidelines for Colorectal Cancer Screening 2008 recommend that clinicians be aware of an increased CRC risk in patients with smoking and obesity, but do not highlight the increase in CRC risk in patients with DM. To provide an updated quantitative assessment of the association of DM with colon cancer (CC) and rectal cancer (RC), we conducted a meta-analysis of case–control and cohort studies. We also evaluated whether the association varied by sex, and assessed potential confounders including obesity, smoking, and exercise. We identified studies by searching the EMBASE and MEDLINE databases (from inception through 31 December 2009) and by searching bibliographies of relevant articles. Summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated with fixed- and random-effects models. Several subgroup analyses were performed to explore potential study heterogeneity and bias. DM was associated with an increased risk of CC (summary RR 1.38, 95% CI 1.26–1.51; n = 14 studies) and RC (summary RR 1.20, 95% CI 1.09–1.31; n = 12 studies). The association remained when we limited the meta-analysis to studies that either controlled for smoking and obesity, or for smoking, obesity, and physical exercise. DM was associated with an increased risk of CC for both men (summary RR 1.43, 95% CI 1.30–1.57; n = 11 studies) and women (summary RR 1.35, 95% CI 1.14–1.53; n = 10 studies). For RC, there was a significant association between DM and cancer risk for men (summary RR 1.22, 95% CI 1.07–1.40; n = 8 studies), but not for women (summary RR 1.09, 95% CI = 0.99–1.19; n = 8 studies). These data suggest that DM is an independent risk factor for colon and rectal cancer. Although these findings are based on observational epidemiological studies that have inherent limitations due to diagnostic bias and confounding, subgroup analyses confirmed the consistency of our findings across study type and population. This information can inform risk models and specialty society CRC screening guidelines.
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影响因子：
3.2
作者：
Deshpande, Anjali D.;Harris-Hayes, Marcie;Schootman, Mario
通讯作者：
Schootman, Mario
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
影响因子：
5
作者：
Bowers, Katherine;Albanes, Demetrius;Stolzenberg-Solomon, Rachael
通讯作者：
Stolzenberg-Solomon, Rachael
影响因子：
39.2
作者：
Cho, EY;Smith-Warner, SA;Hunter, DJ
通讯作者：
Hunter, DJ
影响因子：
3.5
作者：
Botas, P;Delgado, E;Díaz-Cadórniga, FJ
通讯作者：
Díaz-Cadórniga, FJ