Familial aggregation of diabetes and hypertension in a case-control study of colorectal neoplasia

Am J Epidemiol. 2002 Oct 15;156(8):702-13. doi: 10.1093/aje/kwf112.


Familial aggregation of diseases potentially associated with metabolic syndrome (diabetes mellitus, hypertension, and cardiovascular diseases) was assessed in a colonoscopy-based case-control study of colorectal neoplasia in Toronto and Ottawa, Canada, in 1993-1996. Each familial disease was analyzed by logistic regression using generalized estimating equations. Case probands had incident adenomatous polyps (n = 172) or incident (n = 25) or prevalent (n = 132) colorectal cancer (CRC), while control probands (n = 282) had a negative colonoscopy and no history of CRC or polyps. Significant effect modification was evident in the data, with the strongest positive associations between familial diabetes and colorectal neoplasia among older probands with symptoms (parents: odds ratio (OR) = 2.4, 95% confidence interval (CI): 1.2, 4.8; siblings: OR = 5.8, 95% CI: 2.6, 13.3). Familial hypertension was also associated with colorectal neoplasia among probands with symptoms (OR = 1.7, 95% CI: 1.1, 2.6). In stratified analyses, familial diabetes, hypertension, and stroke were positively associated with adenomatous polyps in subgroups of probands who were older and/or had symptoms, while only familial diabetes was possibly associated with CRC. Associations in other proband groups may have been obscured by high cumulative incidence of parental CRC. Family studies are needed to understand the contribution of specific environmental and genetic factors in accounting for the disease aggregations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Colonoscopy
  • Colorectal Neoplasms / complications*
  • Colorectal Neoplasms / epidemiology
  • Colorectal Neoplasms / genetics*
  • Diabetes Complications*
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / genetics*
  • Female
  • Humans
  • Hypertension / complications*
  • Hypertension / epidemiology
  • Hypertension / genetics*
  • Incidence
  • Insulin Resistance
  • Male
  • Medical History Taking
  • Middle Aged
  • Pedigree
  • Regression Analysis