Diabetes and risk of incident colorectal cancer in a prospective cohort of women

Cancer Causes Control. 2010 Aug;21(8):1277-84. doi: 10.1007/s10552-010-9555-0. Epub 2010 Apr 10.


Objective: To determine whether accounting for the time dynamics of diabetes exposure will change the risk estimates for colorectal cancer.

Methods: We analyzed data from the 45, 516 women enrolled in the BCDDP follow-up cohort study. We used proportional hazards regression to obtain multivariable-adjusted risk estimates for incident colorectal cancer for prevalent diabetes at baseline and diabetes as a time-dependent variable.

Results: Subjects with diabetes had a statistically significant increased risk of colorectal cancer compared to subjects without diabetes (RR = 1.60, 95% CI 1.18-2.18). When we defined exposure as duration of diabetes exposure at cohort exit, we found that in the first 4 years after diagnosis risk was essentially the same as in those never having had a diagnosis of diabetes. For those who had been diagnosed between 4 and 8 years previously, however, we observed a RR of 2.36 (95% CI 0.96-5.79), while longer duration of exposure was associated with smaller and then no change in risk compared to those without a diagnosis of diabetes.

Conclusions: These results are consistent with the theory that hyperinsulinemia can explain, at least in part, the association of diabetes with colorectal cancer, but in a time-dependent manner.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Cohort Studies
  • Colorectal Neoplasms / epidemiology*
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperinsulinism / epidemiology
  • Incidence
  • Longitudinal Studies
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • United States / epidemiology