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Study shows Colorectal Cancer Risk Higher in People With Type 2 Diabetes
Study shows Colorectal Cancer Risk Higher in People With Type 2 Diabetes -- Posted by Gumbo on 10-24-04 12:38
Study shows Colorectal Cancer Risk Higher in People With Type 2 Diabetes
BETHESDA, MD -- October 1, 2004 -- A study published today in the American
Gastroenterological Association's journal Gastroenterology concludes that
patients with type 2 diabetes mellitus who require long-term insulin therapy
are at a significantly increased risk for colorectal cancer.
Results of this retrospective cohort study, conducted on 24,918 people with
type 2 diabetes, suggest that those who received more than three years of
insulin therapy during the follow-up period of the study have more than
three times the risk of developing colorectal cancer than those who did not
receive insulin therapy.
The prevalence of type 2 diabetes is at epidemic proportions and many
patients will eventually require insulin therapy to manage their disease.
"It is yet to be determined whether the increased risk of colorectal cancer
is due to a growth promotional effect of exogenous insulin, the severity of
type 2 diabetes mellitus, or both," said Dr. Yu-Xiao Yang, lead study
author. "However, we are hopeful that the identification of this group of
patients at a significantly higher risk of developing colorectal cancer will
lead to more effective cancer prevention efforts."
Patients should not discontinue insulin therapy as a result of this study,
but should ask their doctors about the highly effective colorectal cancer
screening methods currently available. If confirmed in additional studies,
practicing physicians should consider long-term insulin therapy as a marker
of elevated colorectal cancer risk.
Further studies are needed to determine whether a more stringent colorectal
cancer screening program is needed in this population. "At this point, we
advocate for strict adherence to the existing colorectal cancer screening
guidelines in this patient population, as these measures can effectively
reduce the risk of developing colorectal cancer," added Yang.
Colorectal cancer is the second leading cause of cancer-related death in the
United States. Type 2 diabetes is a condition where the body responds poorly
to the insulin that it produces, and has to make an excessive amount of
insulin to overcome the poor response in order to maintain blood sugar
control. At advanced stages, the body produces less and less insulin, until
eventually insulin treatment is needed. Approximately 18 million Americans
have diabetes--90 to 95% of these cases are type 2 diabetes.
Previous studies have suggested that type 2 diabetes mellitus may be
independently associated with increased colorectal cancer risk. Excess
internal insulin production in type 2 diabetes has been proposed as the main
potential reason. However, the effect of externally administered insulin on
cancer risk has not been studied in humans.
The American Gastroenterological Association (AGA) and multiple government
agencies and professional societies underscore the importance of colorectal
cancer screening for all individuals 50 years of age and older. Currently,
there are a number of approved tests that may be used to screen for
colorectal cancer, including barium enema, fecal occult blood test, flexible
sigmoidoscopy and colonoscopy.
About the Study
Lead study author Dr. Yu-Xiao Yang is an instructor of medicine in the
University of Pennsylvania School of Medicine's division of
gastroenterology. Researchers conducted a retrospective cohort study among
all patients with a diagnosis of type 2 diabetes in the General Practice
Research Database, a collection of primary outpatient medical records for
hundreds of general practitioner practices in the United Kingdom. Patient
information in the database includes demographic information, prescription
drugs, diagnoses, hospital admissions and deaths. Of the 24,918 patients
with type 2 diabetes, 3,160 required insulin. Results of the study are
generalized and can be applied to various national populations
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