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

doi:10.1016/j.dsx.2023.102828

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

Diabetes Metab Syndr. 2023 Aug;17(8):102828. doi: 10.1016/j.dsx.2023.102828. Epub 2023 Jul 14.

Authors

Affiliations

¹ PhD Program for Cancer Molecular Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei, Taiwan; Graduate Institute of Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
² International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.
³ School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan.
⁴ Graduate Institute of Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; PhD Program for Cancer Molecular Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
⁵ Graduate Institute of Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
⁶ International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan; Department of Pediatrics, Division of Infectious Disease, University of Medicine Pham Ngoc Thach, Ho Chi Minh City, Viet Nam; Infectious Disease Department, Children's Hospital 2, Ho Chi Minh City, Viet Nam; Department of Pediatrics, Vinmec Central Park International Hospital, Viet Nam.
⁷ Hong Bang International University, Viet Nam.
⁸ Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan; Department of Sports Management, College of Leisure and Recreation Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan. Electronic address: mjnchen117@gmail.com.
⁹ PhD Program for Cancer Molecular Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei, Taiwan; Graduate Institute of Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; PhD Program for Cancer Molecular Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; Cancer Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan; TMU Research Center of Cancer Translational Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address: khlee@tmu.edu.tw.

PMID: 37490785
DOI: 10.1016/j.dsx.2023.102828

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.

Keywords: Diabetes; Early-onset colorectal cancer; Meta-analysis; Systematic review.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

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