Type 2 diabetes, antidiabetic medications, and colorectal cancer risk: two case-control studies from Italy and Spain

Frontiers in Oncology

Federica E. Pisa¹  Esther Gracia-Lavedan²  Jerry Polesel³  Diego Serraino³  Elisabet Guinó⁴  Gemma Castaño-Vinyals⁶  Cristina M. Villanueva⁶  Manolis Kogevinas⁶  Cristina Bosetti⁷  Valentina Rosato⁷  Alessandra Tavani⁷  Victor Moreno⁹  Carlo La Vecchia^1,10  Fabio Barbone^1,11 

[1] Azienda Ospedaliero Universitaria di Udine;CIBER Epidemiología y Salud Pública (CIBERESP);CRO Aviano National Cancer Institute, IRCCS;Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO)-IDIBELL. Hospitalet de Llobregat;Centre for Research in Environmental Epidemiology (CREAL);IMIM (Hospital del Mar Medical Research Institute);IRCCS-Istituto di Ricerche Farmacologiche Mario Negri;Universitat Pompeu Fabra (UPF);University of Barcelona;Università degli Studi di Milano;Università di Udine Udine;

关键词: Insulin;    Metformin;    colorectal cancer;    diabetes;    risk factor.;    Antidiabetic medications;   

DOI  :  10.3389/fonc.2016.00210

来源: DOAJ

【 摘 要 】

Background: Type 2 diabetes mellitus has been associated with an excess risk of colorectal cancer, although the time-risk relationship is unclear and there is limited information on the role of antidiabetic medications.Aim: We examined the association between type 2 diabetes, antidiabetic medications, and the risk of colorectal cancer, considering also duration of exposures.Methods: Data derived from two companion case-control studies conducted in Italy and Spain between 2007 and 2013 on 1,147 histologically confirmed colorectal cancer cases and 1,594 corresponding controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by unconditional multiple logistic regression models, adjusted for socioeconomic factors and major potential confounding factors.Results: Overall, 14% of cases and 12% of controls reported a diagnosis of diabetes, corresponding to an OR of colorectal cancer of 1.21 (95% CI 0.95-1.55). The OR was 1.49 (95% CI 0.97-2.29) for a duration of diabetes of at least 15 years. The OR was 1.53 (95% CI 1.06-2.19) for proximal colon cancer, 0.94 (95% CI 0.66-1.36) for distal colon cancer, and 1.32 (95% CI 0.94-1.87) for rectal cancer. In comparison with no use, metformin use was associated with a decreased colorectal cancer risk (OR 0.47, 95% CI 0.24-0.92), while insulin use was associated with an increased risk (OR 2.20, 95% CI 1.12-4.33); these associations were stronger for longer use (OR 8.18 for ≥ 10 years of use). Conclusion: This study shows evidence of a positive association between diabetes and colorectal cancer, mainly proximal colon cancer. Moreover, it indicates a negative association between colorectal cancer and metformin use and a positive association for insulin use.

【 授权许可】

Unknown