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Women With Type 2 Diabetes at Increased Risk of Colorectal Adenomas: Presented by DDW

By Bruce Sylvester

LOS ANGELES, C.A. -- May 23, 2006 -- Women with type 2 diabetes show higher rates of colorectal adenomas than lean, nondiabetic women, researchers reported here at Digestive Diseases Week 2006 (DDW).

"We found that type 2 diabetics had up to a 2- to 3-fold increased risk of having any adenoma or advanced adenomas, which are precancerous polyps," said presenter and lead investigator Jill Elwing, MD, gastroenterology fellow, Washington University School of Medicine, St. Louis, Missouri. "The most clinically significant impact of this finding is that diabetics should undergo colon-cancer screening because of their increased risk for colon polyps."

The authors noted that despite prior studies linking insulin resistance to increased colorectal cancer (CRC) risk, the available data are limited on colorectal adenoma risk in diabetic women. "We hypothesized that diabetic women would have increased rates of colorectal adenomas relative to a group of nondiabetic women," they wrote.

The investigators gathered and evaluated data on 100 women with type 2 diabetes mellitus (average 60 years of age ± 9.5 years, 41% Caucasian, 10% with a first-degree relative with CRC, body mass index [BMI] 34.4 ± 8.0, 29% on insulin therapy) and 500 nondiabetic, hormone-status-matched controls (59.0 years of age ± 9.2 years, 68% Caucasian, 7% with a first-degree relative with CRC, BMI 28.5 ± 7.1).

The subjects were selected from women receiving screening colonoscopy at an outpatient university endoscopy center.

The researchers defined "adenoma" as any adenoma or advanced adenoma, villous or tubulovillous, and greater than 1 cm or with high-grade dysplasia.

The researchers reported that diabetics compared with nondiabetics showed increased rates of any adenoma (37% vs 24%) and advanced adenomas (14% vs 6%).

They also found that 245 obese subjects compared with 321 nonobese subjects showed increased rates of any adenoma (32% vs 22%). Obese diabetics compared with nonobese, nondiabetic subjects showed increased rates of any adenoma (42% vs 23%) and advanced adenomas (19% vs 7%).

The team added that multivariate analysis (including age, race, diabetes, hypertension, hypercholesterolemia, and BMI) disclosed that adenomas and advanced adenomas were independently predicted by diabetes and, for adenomas, by age.

"This finding adds to the evidence that type 2 diabetes is an important factor in the progression of the adenoma-carcinoma sequence," the authors concluded.

This poster presentation was cited by Digestive Diseases Week as a "Poster of Distinction."


[Presentation title: Type 2 Diabetes Mellitus: The Impact on Colorectal Adenoma Risk in Women. Abstract S1245]

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