Type 2 Diabetes, antidiabetic medications, and colorectal cancer risk: two case-control studies from Italy and Spain

Rosato, Valentina; Tavani, Alessandra; Gràcia Lavedan, Esther; Guinó, Elisabet; Castaño Vinyals, Gemma; Villanueva Belmonte, Cristina; Kogevinas, Manolis; Polesel, Jerry; Serraino, Diego; Pisa, Federica; Barbone, Fabio; Moreno, Víctor; La Vecchia, Carlo; Bosetti, Cristina

Type 2 Diabetes, antidiabetic medications, and colorectal cancer risk: two case-control studies from Italy and Spain

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dc.contributor.author Rosato, Valentinaca
dc.contributor.author Tavani, Alessandraca
dc.contributor.author Gràcia Lavedan, Estherca
dc.contributor.author Guinó, Elisabetca
dc.contributor.author Castaño Vinyals, Gemmaca
dc.contributor.author Villanueva Belmonte, Cristinaca
dc.contributor.author Kogevinas, Manolisca
dc.contributor.author Polesel, Jerryca
dc.contributor.author Serraino, Diegoca
dc.contributor.author Pisa, Federicaca
dc.contributor.author Barbone, Fabioca
dc.contributor.author Moreno, Víctorca
dc.contributor.author La Vecchia, Carloca
dc.contributor.author Bosetti, Cristinaca
dc.date.accessioned 2017-01-23T10:54:35Z
dc.date.available 2017-01-23T10:54:35Z
dc.date.issued 2016
dc.description.abstract BACKGROUND: Type 2 diabetes mellitus has been associated with an excess risk of colorectal cancer, although the time-risk relationship is unclear, and there is limited information on the role of antidiabetic medications. AIM: We examined the association between type 2 diabetes, antidiabetic medications, and the risk of colorectal cancer, considering also duration of exposures. METHODS: We analyzed data derived from two companion case-control studies conducted in Italy and Spain between 2007 and 2013 on 1,147 histologically confirmed colorectal cancer cases and 1,594 corresponding controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by unconditional multiple logistic regression models, adjusted for socioeconomic factors and major potential confounding factors. RESULTS: Overall, 14% of cases and 12% of controls reported a diagnosis of diabetes, corresponding to an OR of colorectal cancer of 1.21 (95% CI 0.95-1.55). The OR was 1.49 (95% CI 0.97-2.29) for a duration of diabetes of at least 15 years. The OR was 1.53 (95% CI 1.06-2.19) for proximal colon cancer, 0.94 (95% CI 0.66-1.36) for distal colon cancer, and 1.32 (95% CI 0.94-1.87) for rectal cancer. In comparison with no use, metformin use was associated with a decreased colorectal cancer risk (OR 0.47, 95% CI 0.24-0.92), while insulin use was associated with an increased risk (OR 2.20, 95% CI 1.12-4.33); these associations were stronger for longer use (OR 0.36 and 8.18 for ≥10 years of use of metformin and insulin, respectively). CONCLUSION: This study shows evidence of a positive association between diabetes and colorectal cancer, mainly proximal colon cancer. Moreover, it indicates a negative association between colorectal cancer and metformin use and a positive association for insulin use.ca
dc.description.sponsorship This work was supported by the HIWATE EU Project (Grant No. 036224), the Italian Association for Research on Cancer (AIRC, Grant No. 13203), the Catalan Government DURSI (Grant No. 2014SGR647), and by Instituto de Salud Carlos III co-funded by FEDER funds (Grant No. PI08-1359, PI14-0613). The funding sources did not have any role in study design, data collection, statistical analysis, interpretation of data, and in the manuscript writing.
dc.format.mimetype application/pdfca
dc.identifier.citation Rosato V, Tavani A, Gracia-Lavedan E, Guinó E, Castaño-Vinyals G, Villanueva CM et al. Type 2 Diabetes, antidiabetic medications, and colorectal cancer risk: two case-control studies from Italy and Spain. Front Oncol. 2016 Oct 6;6:210. DOI: 10.3389/fonc.2016.00210ca
dc.identifier.doi http://dx.doi.org/10.3389/fonc.2016.00210
dc.identifier.issn 2234-943X
dc.identifier.uri http://hdl.handle.net/10230/27955
dc.language.iso engca
dc.publisher Frontiersca
dc.relation.ispartof Frontiers in Oncology. 2016 Oct 6;6:210
dc.rights © The Author(s). 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.ca
dc.rights.accessRights info:eu-repo/semantics/openAccessca
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ca
dc.subject.other Diabetis -- Tractamentca
dc.subject.other Còlon -- Càncerca
dc.subject.other Insulinaca
dc.subject.other Malalties -- Factors de riscca
dc.title Type 2 Diabetes, antidiabetic medications, and colorectal cancer risk: two case-control studies from Italy and Spainca
dc.type info:eu-repo/semantics/articleca
dc.type.version info:eu-repo/semantics/publishedVersionca

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