Diabetes mellitus and colorectal carcinoma outcomes: a meta-analysis
- PDF / 1,542,292 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 8 Downloads / 186 Views
ORIGINAL ARTICLE
Diabetes mellitus and colorectal carcinoma outcomes: a meta-analysis Daniel J. Becker 1 & Arjun D. Iyengar 1 & Salman R. Punekar 1 Heather T. Gold 1
&
Dalia Kaakour 2 & Megan Griffin 1 & Joseph Nicholson 1 &
Accepted: 10 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives The impact of diabetes mellitus (DM) on colorectal cancer (CRC) outcomes remains unknown. We studied this by conducting a meta-analysis to evaluate (1) CRC outcomes with and without DM and (2) treatment patterns. Methods We searched PubMed, EMBASE, Google Scholar, and CINAHL for full-text English studies from 1970 to 12/31/2017. We searched keywords, subject headings, and MESH terms to locate studies of CRC outcomes/treatment and DM. Studies were evaluated by two oncologists. Of 14,332, 48 met inclusion criteria. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method, we extracted study location, design, DM definition, covariates, comparison groups, outcomes, and relative risks and/or hazard ratios. We utilized a random-effects model to pool adjusted risk estimates. Primary outcomes were all-cause mortality (ACM), disease-free survival (DFS), relapse-free survival (RFS), and cancer-specific survival (CSS). The secondary outcome was treatment patterns. Results Forty-eight studies were included, 42 in the meta-analysis, and 6 in the descriptive analysis, totaling > 240,000 patients. ACM was 21% worse (OR 1.21, 95% CI 1.15–1.28) and DFS was 75% worse (OR 1.75, 95% CI: 1.33–2.31) in patients with DM. No differences were detected in CSS (OR 1.10, 95% CI 0.98–1.23) or RFS (OR 1.12, 95% CI 0.91–1.38). Descriptive analysis of treatment patterns in CRC and DM suggested potentially less adjuvant therapy use in cases with DM and CRC. Conclusions Our meta-analysis suggests that patients with CRC and DM have worse ACM and DFS than patients without DM, suggesting that non-cancer causes of death in may account for worse outcomes. Keywords Diabetes mellitus . Colorectal carcinoma . Outcomes . All-cause mortality . Meta-analysis
Introduction Colorectal cancer (CRC) is the third most common cancer worldwide with an estimated 1.8 million new CRC cases and 881,000 deaths in 2018 [1]. Similarly, diabetes mellitus (DM) is one of the most important public health problems
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00384-020-03666-z) contains supplementary material, which is available to authorized users. * Salman R. Punekar [email protected] 1
Grossman School of Medicine, New York University, New York, NY 10016, USA
2
Miller School of Medicine, University of Miami, Miami, FL, USA
worldwide, with an estimated 2017 worldwide prevalence of 495 million cases and 4 million deaths [2]. Multiple studies have reported that DM is a risk factor for the development of CRC, with an estimated increase in risk of 20–40% [3–7]. Proposed mechanisms for development of CRC in patients with DM include the effect of insu
Data Loading...
