title: Diabetes Mellitus and Colorectal Neoplasia.
abstract: Many studies have provided evidence for an association between obesity, physical inactivity, and western diet as risk factors for colorectal cancer (CRC). Few studies directly address the association between type 2 Diabetes Mellitus (DM) and the risk of colorectal lesions at specific anatomic locations.
  
  
  
  2,663 subjects with a previous history of adenoma(s) and removal of all current adenomas at study entry were followed for a mean time of three years across three different chemoprevention clinical trials. The primary endpoint was colorectal adenoma recurrence and number of lesions during the treatment phase; the secondary endpoints were presence of advanced colorectal neoplasia (CRN) and location of CRN. Using log linear regression, the effect of DM status on the relative risk (RR) of CRN recurrence, advanced CRN, and location of CRN was assessed.
  
  
  
  DM status was not significantly associated with incidence of colorectal adenomas, incidence of advanced colorectal lesions, or left-sided colorectal neoplastic lesions. Subjects with DM had a marginally increased risk of right-sided (p= 0.06) colorectal adenomas and a significant increased risk of multiple right-sided adenomas (p=0.03) in the unadjusted model; this association was not significant after adjusting for age and other potential confounders (RR=1.22, 95% CI: 0.85-1.76).
  
  
  
  We did not observe a statistically significant increased risk in CRN recurrence for overall neoplasia, advanced neoplasia or location of neoplasia in individuals with DM compared to non-DM individuals. However, given the patterns observed in this investigation, future studies with longer follow-up time and longer DM exposure, incorporating objective measurements of type 2 DM might help elucidate the risk of CRN among individuals with DM.
authors.affiliation: Department of Medicine, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Acevedo
authors.forename: Yaritza
authors.initials: Y
authors.lastname: Diaz
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Perez
authors.forename: Maria
authors.initials: M
authors.lastname: Garau
authors.forename: John
authors.initials: J
authors.lastname: Baron
authors.forename: Marcia
authors.initials: M
authors.lastname: Cruz-Correa
keywords: Diabetes mellitus; chemoprevention; colorectal adenomas; colorectal neoplasia
references.citation: Am J Surg Pathol. 2003 Jan;27(1):65-81
references.pmid: 12502929
references.citation: N Engl J Med. 1994 Jul 21;331(3):141-7
references.pmid: 8008027
references.citation: Am J Epidemiol. 1989 Jul;130(1):173-87
references.pmid: 2741904
references.citation: Cancer Res. 1997 Nov 1;57(21):4787-94
references.pmid: 9354440
references.citation: Am J Gastroenterol. 2006 Aug;101(8):1872-9
references.pmid: 16790032
references.citation: Am J Epidemiol. 1986 Sep;124(3):453-69
references.pmid: 3740045
references.citation: Clin Gastroenterol Hepatol. 2005 Jun;3(6):587-94
references.pmid: 15952101
references.citation: CA Cancer J Clin. 2010 Sep-Oct;60(5):277-300
references.pmid: 20610543
references.citation: Cancer Epidemiol Biomarkers Prev. 2005 Jan;14(1):133-7
references.pmid: 15668486
references.citation: Diabetes Res Clin Pract. 2010 Jan;87(1):4-14
references.pmid: 19896746
references.citation: Gastroenterology. 2010 Oct;139(4):1138-46
references.pmid: 20633560
references.citation: Am J Gastroenterol. 2006 Aug;101(8):1866-71
references.pmid: 16790036
references.citation: J Clin Epidemiol. 1990;43(12):1327-35
references.pmid: 2254769
references.citation: Diabetes Obes Metab. 2008 Mar;10(3):198-211
references.pmid: 18269635
references.citation: N Engl J Med. 1999 Jan 14;340(2):101-7
references.pmid: 9887161
references.citation: N Engl J Med. 2003 Mar 6;348(10):883-90
references.pmid: 12621132
references.citation: Ann N Y Acad Sci. 1999;889:138-45
references.pmid: 10668490
references.citation: Cancer Epidemiol Biomarkers Prev. 2004 Jun;13(6):915-9
references.pmid: 15184246
references.citation: Am J Epidemiol. 2001 Dec 15;154(12):1089-99
references.pmid: 11744511
references.citation: Br J Cancer. 2001 Feb 2;84(3):417-22
references.pmid: 11161410
references.citation: N Engl J Med. 2003 Mar 6;348(10):891-9
references.pmid: 12621133
references.citation: J Natl Cancer Inst. 2005 Nov 16;97(22):1679-87
references.pmid: 16288121
references.citation: Am J Epidemiol. 2006 Oct 1;164(7):652-64
references.pmid: 16877536