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Title: Diabetes and risk of incident colorectal cancer in a prospective cohort of women.
Authors: Flood A,  Strayer L,  Schairer C,  Schatzkin A
Journal: Cancer Causes Control
Date: 2010 Aug
Branches: BB, MEB
PubMed ID: 20383575
PMC ID: PMC2904413
Abstract: OBJECTIVE: To determine whether accounting for the time dynamics of diabetes exposure will change the risk estimates for colorectal cancer. METHODS: We analyzed data from the 45, 516 women enrolled in the BCDDP follow-up cohort study. We used proportional hazards regression to obtain multivariable-adjusted risk estimates for incident colorectal cancer for prevalent diabetes at baseline and diabetes as a time-dependent variable. RESULTS: Subjects with diabetes had a statistically significant increased risk of colorectal cancer compared to subjects without diabetes (RR = 1.60, 95% CI 1.18-2.18). When we defined exposure as duration of diabetes exposure at cohort exit, we found that in the first 4 years after diagnosis risk was essentially the same as in those never having had a diagnosis of diabetes. For those who had been diagnosed between 4 and 8 years previously, however, we observed a RR of 2.36 (95% CI 0.96-5.79), while longer duration of exposure was associated with smaller and then no change in risk compared to those without a diagnosis of diabetes. CONCLUSIONS: These results are consistent with the theory that hyperinsulinemia can explain, at least in part, the association of diabetes with colorectal cancer, but in a time-dependent manner.