Colorectal Cancer Outcomes, Recurrence, and Complications in Persons With and Without Diabetes Mellitus: A Systematic Review and Meta-Analysis
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Diabetes mellitus increases the risk of incident colorectal cancer, but it is less clear if pre-existing diabetes mellitus influences mortality outcomes, recurrence risk, and/or treatment-related complications in persons with colorectal cancer.
We performed a systematic review and meta-analysis comparing colorectal cancer mortality outcomes, cancer recurrence, and treatment-related complications in persons with and without diabetes mellitus. We searched MEDLINE and EMBASE through October 1, 2008, including hand-searching references of qualifying articles. We included studies in English that evaluated diabetes mellitus and cancer treatment outcomes, prognosis, and/or mortality. The initial search identified 8,208 titles, of which 15 articles met inclusion criteria. Each article was abstracted by one author using a standardized form and re-reviewed by another author for accuracy. Authors graded quality based on pre-determined criteria.
We found significantly increased short-term perioperative mortality in persons with diabetes mellitus. In the meta-analysis of long-term mortality, persons with diabetes mellitus had a 32% increase in all-cause mortality compared to those without diabetes mellitus (95% CI: 1.24, 1.41). Although data on other outcomes are limited, available studies suggest that pre-existing diabetes mellitus predicts increased risk of some post-operative complications as well as 5-year cancer recurrence. In contrast, there is little evidence that diabetes confers increased risk for long-term cancer-specific mortality.
Patients with colorectal cancer and pre-existing diabetes mellitus have an increased risk of short- and long-term mortality. Future research should determine whether improvements in prevention and treatment of diabetes mellitus will improve outcomes for colorectal cancer patients.
- Colorectal Cancer Outcomes, Recurrence, and Complications in Persons With and Without Diabetes Mellitus: A Systematic Review and Meta-Analysis
Digestive Diseases and Sciences
Volume 55, Issue 7 , pp 1839-1851
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- Print ISSN
- Online ISSN
- Springer US
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- Colorectal carcinoma
- Diabetes mellitus
- Treatment outcome
- Fatal outcome
- Industry Sectors
- Author Affiliations
- 1. Johns Hopkins School of Medicine, Baltimore, MD, USA
- 2. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- 4. Division of General Internal Medicine, Johns Hopkins School of Medicine, 600 N. Wolfe St, Baltimore, MD, 21205, USA
- 5. Division of General Internal Medicine, Johns Hopkins School of Medicine, 624 N. Broadway, Hampton House, Room 657, Baltimore, MD, 21205, USA
- 6. 2024 East Monument St, Baltimore, MD, 21205, USA
- 7. Division of General Internal Medicine, Johns Hopkins School of Medicine, 2024 East Monument St, Baltimore, MD, 21205, USA
- 8. Division of General Internal Medicine, Johns Hopkins School of Medicine, 10753 Falls Road, Suite 325, Lutherville, MD, 21093, USA
- 9. Center for Medicine Endocrinology and Diabetes, 5667 Peachtree Dunwoody Rd, Suite 150, Atlanta, GA, 30342, USA
- 3. Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University Medical Institutions, 1650 Orleans St, CRB Room 189, Baltimore, MD, 21231, USA
- 10. Division of General Internal Medicine, Welch Center for Prevention, Epidemiology, and Clinical Research, 2024 East Monument St, Room 2-619, Baltimore, MD, 21205, USA