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Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study

BACKGROUND: Colorectal cancer (CRC) incidence is increasing among young adults below screening age, despite the effectiveness of screening in older populations. Individuals with diabetes mellitus are at increased risk of early-onset CRC. We aimed to determine how many years earlier than the general...

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Autores principales: Ali Khan, Uzair, Fallah, Mahdi, Sundquist, Kristina, Sundquist, Jan, Brenner, Hermann, Kharazmi, Elham
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7665813/
https://www.ncbi.nlm.nih.gov/pubmed/33186354
http://dx.doi.org/10.1371/journal.pmed.1003431
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author Ali Khan, Uzair
Fallah, Mahdi
Sundquist, Kristina
Sundquist, Jan
Brenner, Hermann
Kharazmi, Elham
author_facet Ali Khan, Uzair
Fallah, Mahdi
Sundquist, Kristina
Sundquist, Jan
Brenner, Hermann
Kharazmi, Elham
author_sort Ali Khan, Uzair
collection PubMed
description BACKGROUND: Colorectal cancer (CRC) incidence is increasing among young adults below screening age, despite the effectiveness of screening in older populations. Individuals with diabetes mellitus are at increased risk of early-onset CRC. We aimed to determine how many years earlier than the general population patients with diabetes with/without family history of CRC reach the threshold risk at which CRC screening is recommended to the general population. METHODS AND FINDINGS: A nationwide cohort study (follow-up:1964–2015) involving all Swedish residents born after 1931 and their parents was carried out using record linkage of Swedish Population Register, Cancer Registry, National Patient Register, and Multi-Generation Register. Of 12,614,256 individuals who were followed between 1964 and 2015 (51% men; age range at baseline 0–107 years), 162,226 developed CRC, and 559,375 developed diabetes. Age-specific 10-year cumulative risk curves were used to draw conclusions about how many years earlier patients with diabetes reach the 10-year cumulative risks of CRC in 50-year-old men and women (most common age of first screening), which were 0.44% and 0.41%, respectively. Diabetic patients attained the screening level of CRC risk earlier than the general Swedish population. Men with diabetes reached 0.44% risk at age 45 (5 years earlier than the recommended age of screening). In women with diabetes, the risk advancement was 4 years. Risk was more pronounced for those with additional family history of CRC (12–21 years earlier depending on sex and benchmark starting age of screening). The study limitations include lack of detailed information on diabetes type, lifestyle factors, and colonoscopy data. CONCLUSIONS: Using high-quality registers, this study is, to our knowledge, the first one that provides novel evidence-based information for risk-adapted starting ages of CRC screening for patients with diabetes, who are at higher risk of early-onset CRC than the general population.
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spelling pubmed-76658132020-11-18 Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study Ali Khan, Uzair Fallah, Mahdi Sundquist, Kristina Sundquist, Jan Brenner, Hermann Kharazmi, Elham PLoS Med Research Article BACKGROUND: Colorectal cancer (CRC) incidence is increasing among young adults below screening age, despite the effectiveness of screening in older populations. Individuals with diabetes mellitus are at increased risk of early-onset CRC. We aimed to determine how many years earlier than the general population patients with diabetes with/without family history of CRC reach the threshold risk at which CRC screening is recommended to the general population. METHODS AND FINDINGS: A nationwide cohort study (follow-up:1964–2015) involving all Swedish residents born after 1931 and their parents was carried out using record linkage of Swedish Population Register, Cancer Registry, National Patient Register, and Multi-Generation Register. Of 12,614,256 individuals who were followed between 1964 and 2015 (51% men; age range at baseline 0–107 years), 162,226 developed CRC, and 559,375 developed diabetes. Age-specific 10-year cumulative risk curves were used to draw conclusions about how many years earlier patients with diabetes reach the 10-year cumulative risks of CRC in 50-year-old men and women (most common age of first screening), which were 0.44% and 0.41%, respectively. Diabetic patients attained the screening level of CRC risk earlier than the general Swedish population. Men with diabetes reached 0.44% risk at age 45 (5 years earlier than the recommended age of screening). In women with diabetes, the risk advancement was 4 years. Risk was more pronounced for those with additional family history of CRC (12–21 years earlier depending on sex and benchmark starting age of screening). The study limitations include lack of detailed information on diabetes type, lifestyle factors, and colonoscopy data. CONCLUSIONS: Using high-quality registers, this study is, to our knowledge, the first one that provides novel evidence-based information for risk-adapted starting ages of CRC screening for patients with diabetes, who are at higher risk of early-onset CRC than the general population. Public Library of Science 2020-11-13 /pmc/articles/PMC7665813/ /pubmed/33186354 http://dx.doi.org/10.1371/journal.pmed.1003431 Text en © 2020 Ali Khan et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Ali Khan, Uzair
Fallah, Mahdi
Sundquist, Kristina
Sundquist, Jan
Brenner, Hermann
Kharazmi, Elham
Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study
title Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study
title_full Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study
title_fullStr Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study
title_full_unstemmed Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study
title_short Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study
title_sort risk of colorectal cancer in patients with diabetes mellitus: a swedish nationwide cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7665813/
https://www.ncbi.nlm.nih.gov/pubmed/33186354
http://dx.doi.org/10.1371/journal.pmed.1003431
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