Cancer Causes & Control

, Volume 24, Issue 2, pp 277–285

Racial disparities in colorectal cancer incidence by type 2 diabetes mellitus status

  • Philip P. Cavicchia
  • Swann Arp Adams
  • Susan E. Steck
  • James R. Hussey
  • Jihong Liu
  • Virginie G. Daguisé
  • James R. Hebert
Original Paper

DOI: 10.1007/s10552-012-0095-7

Cite this article as:
Cavicchia, P.P., Adams, S.A., Steck, S.E. et al. Cancer Causes Control (2013) 24: 277. doi:10.1007/s10552-012-0095-7

Abstract

Purpose

Type 2 diabetes mellitus (T2DM) prevalence has increased dramatically in the United States since the early 1970s. Though T2DM is known to be associated with colorectal cancer (CRC), information on racial differences in the relationship between T2DM and CRC is limited.

Methods

Using a retrospective cohort design, we compared the association between T2DM and CRC, including subsites of the colon, in African Americans (AAs) and European Americans (EAs) in South Carolina, a region with large racial disparities in rates of both diseases. A total of 91,836 individuals who were ≥30 years old on 1 January 1990 and had ≥12 months of South Carolina Medicaid eligibility between 1 January 1990 and 31 December 1995 were included in the analyses. Cancer data from 1996 to 2007 included information on anatomic subsite.

Results

Subjects who had T2DM (n = 6,006) were >50 % more likely to be diagnosed with colon cancer compared to those without T2DM (n = 85,681). The association between T2DM and colon cancer was higher in AAs [odds ratio (OR) = 1.72 (95 % confidence interval: 1.21, 2.46); n = 47,984] than among EAs (OR = 1.24; 0.73, 2.11; n = 43,703). Overall, individuals with T2DM were over twice as likely to be diagnosed with in situ or local colon cancer (OR = 2.12; 1.40, 3.22; n = 191) compared to those without T2DM, with a higher likelihood among AAs (OR = 2.49; 1.52, 4.09; n = 113).

Conclusions

Results from a Medicaid population in a high-risk region of the United States showed an increased likelihood of CRC with T2DM and suggest a racial disparity that disfavors AAs and provides further impetus for efforts aimed at diabetes prevention in this group.

Keywords

Cohort study design Colorectal cancer Diabetes mellitus type 2 Health status disparities Incidence South Carolina 

Abbreviations

AAs

African Americans

CRC

Colorectal cancer

EAs

European Americans

OR

Odds ratio

SCCCR

South Carolina Central Cancer Registry

SIR

Standardized incidence ratio

T2DM

Type 2 diabetes mellitus

Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Philip P. Cavicchia
    • 1
    • 2
    • 3
  • Swann Arp Adams
    • 1
    • 2
    • 5
  • Susan E. Steck
    • 1
    • 2
  • James R. Hussey
    • 2
  • Jihong Liu
    • 2
  • Virginie G. Daguisé
    • 4
  • James R. Hebert
    • 1
    • 2
  1. 1.South Carolina Statewide Cancer Prevention and Control ProgramUniversity of South CarolinaColumbiaUSA
  2. 2.Department of Epidemiology and Biostatistics, Arnold School of Public HealthUniversity of South CarolinaColumbiaUSA
  3. 3.Florida Department of HealthTallahasseeUSA
  4. 4.South Carolina Department of Health and Environmental ControlColumbiaUSA
  5. 5.College of NursingUniversity of South CarolinaColumbiaUSA

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