Association of diabetes mellitus with early-onset colorectal cancer: A systematic review and meta-analysis of 19 studies including 10 million individuals and 30,000 events

Hoang Dang Khoa Ta, Nam Nhat Nguyen, Dang Khanh Ngan Ho, Hieu Duc Nguyen, Yi-Chun Ni, Ke Xin Yee, Syu-Ruei Pan, Hung Song Nguyen, Thao Thai Hoang Phuoc, Ming-Jenn Chen, Kuen-Haur Lee

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Abstract

BACKGROUND AND AIMS: Early-onset colorectal cancer (EoCRC) constitutes 2%-10% of all colorectal cancers and is becoming more common globally. Diabetes mellitus (DM) has increased substantially in younger adults; however, its involvement in EoCRC remains unclear. We conducted a systematic review and meta-analysis of observational studies to (1) explore the prevalence of DM in individuals with EoCRC and (2) investigate the association between DM and EoCRC.

METHODS: A systematic literature search was conducted to identify studies published before May 2022 that evaluated the association between DM and EoCRC risk in four databases, including Medline (PubMed), Embase, Web of Science, and the Cochrane Central Register of Controlled Trials. Results from the studies were summarized in meta-analyses using random effects models.

RESULTS: Nineteen eligible studies were included. A total of 33,359 EoCRC cases and 14,259,289 controls in 12 studies were included in the meta-analysis. The pooled odds ratio [OR] of 1.43 (95% confidence interval [CI]: 1.08-1.8) indicated significant positive association between DM and increased risk of EoCRC. Subgroup analysis demonstrated that diabetes severity was significantly associated with unmanaged DM (OR = 1.28, 95% CI: 1.02-1.6), but not with managed DM (OR = 1.04, 95% CI: 0.84-1.28).

CONCLUSION: Our results suggest that DM is a risk factor for EoCRC, and the higher prevalence of DM among younger adults may contribute to the increasing incidence of EoCRC. Interventions to reduce this bidirectional risk should be further investigated for the development of effective prevention and treatment strategies. PROSPERO registration: CRD42022306347.

Original languageEnglish
Pages (from-to)102828
JournalDiabetes and Metabolic Syndrome: Clinical Research and Reviews
Volume17
Issue number8
DOIs
Publication statusPublished - Aug 17 2023

Keywords

  • Adult
  • Humans
  • Diabetes Mellitus/epidemiology
  • Risk Factors
  • Odds Ratio
  • Prevalence
  • Colorectal Neoplasms/epidemiology

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