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Digestive Diseases and Sciences

, Volume 57, Issue 6, pp 1576–1585 | Cite as

Diabetes Mellitus and the Incidence of Colorectal Cancer: An Updated Systematic Review and Meta-Analysis

  • Longying Deng
  • Zhifu Gui
  • Lianying Zhao
  • Jianping Wang
  • Lizong ShenEmail author
Review

Abstract

Aim

The purpose of this study was to determine whether diabetes mellitus is associated with an increased risk of colorectal cancer.

Methods

Relevant studies were identified in MEDLINE and EMBASE (up until November 1st, 2011). Inclusion criteria were original, peer-reviewed publications, with case–control and cohort studies (for studies on diabetes mellitus and colorectal cancer). Summary relative risks with 95% confidence intervals were calculated with a random-effects model.

Results

Twenty-four studies including eight case–control and 16 cohort studies, with a total of 3,659,341 participants, were included in this updated systematic review and meta-analysis, and all involved diabetes mellitus and colorectal cancer risk. Meta-analysis of the 24 included studies indicated that diabetes was associated with an increased risk of colorectal cancer, compared with no diabetes (summary RR of colorectal cancer incidence = 1.26, 95% CI = 1.20–1.31), without heterogeneity between studies (P heterogeneity = 0.296). Sub-group analyses found that these results were consistent between case–control and cohort studies and among studies conducted in different areas. The association between diabetes and colorectal cancer incidence did not differ significantly by sex and sub-sites. Insulin therapy was also positively associated with risk of colorectal cancer (summary RR = 1.61, 95% CI 1.18–1.35), with evidence of heterogeneity between studies (P heterogeneity = 0.014).

Conclusions

Our findings further support a relationship between diabetes and increased risk of colon and rectal cancer in both women and men, and insulin therapy for diabetes may increase this risk.

Keywords

Diabetes mellitus Colorectal cancer Risk Meta-analysis 

Notes

Acknowledgments

This work was supported by Qing Lan Project and the 7th “Six-Talent-Person-Peak Program,” Jiangsu Province, China. The authors are grateful to Dr. Christopher J. Fleming for his critical review of the manuscript.

Conflict of interest

The authors declare no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Longying Deng
    • 1
  • Zhifu Gui
    • 1
  • Lianying Zhao
    • 2
  • Jianping Wang
    • 1
  • Lizong Shen
    • 1
    Email author
  1. 1.Division of Gastrointestinal Surgery, Department of General Surgery, First Affiliated HospitalNanjing Medical UniversityNanjingPeople’s Republic of China
  2. 2.Department of Epidemiology and Biostatistics, School of Public HealthNanjing Medical UniversityNanjingPeople’s Republic of China

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