期刊
DIABETES CARE
卷 38, 期 3, 页码 495-502出版社
AMER DIABETES ASSOC
DOI: 10.2337/dc14-1175
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资金
- European Union [282526]
- CARING project
- Innovative Medicines Initiative (IMI), Top Institute Pharma (TI Pharma)
- Netherlands Organization for Health Research and Development
- Dutch Health Care Insurance Board
- Royal Dutch Pharmacists Association
- European Union/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Program
- European Union
- Dutch Medicines Evaluation Board
- Dutch Ministry of Health, and industry
- GlaxoSmithKline
- Pfizer
OBJECTIVE To assess the risk of colorectal cancer associated with type 2 diabetes, as compared with a nondiabetic reference population, and to study additional associations between treatment stage and duration of obesity and colorectal cancer risk. RESEARCH DESIGN AND METHODS We conducted an observational population-based cohort study within the Clinical Practice Research Datalink (1987-2012). All patients (>= 18 years) with at least one prescription for an antidiabetic drug (n = 300,039) were matched (1: 1) by birth year, sex, and practice to a comparison cohort without diabetes. Cox proportional hazards models were used to derive adjusted hazard ratios (HRs) for colorectal cancer associated with type 2 diabetes. Within the diabetic cohort, associations of colorectal cancer with treatment stages and duration of obesity (BMI >= 30 kg/m(2)) were studied. RESULTS After amedian follow-up of 4.5 years, 2,759 cases of colorectal cancer were observed among the diabetic study population. Type 2 diabetes was associated with a 1.3-fold increased risk of colorectal cancer (HR 1.26 [95% CI 1.18-1.33]). Among diabetic patients, no association was found with treatment stages. A trend of increased colorectal cancer risk was observed with longer duration of obesity. Risk of colorectal cancer was significantly increased for patients with recorded duration of obesity of 4-8 years (HR 1.19 [1.06-1.34]) and >8 years (1.28 [1.11-1.49]). CONCLUSIONS Type 2 diabetes is associated with a moderately increased risk of colorectal cancer. Among diabetic patients, an increased risk was observed for patients who suffered from obesity for a total duration of 4 years or more.
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