Retrospective Study
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World J Gastroenterol. Jun 14, 2014; 20(22): 6946-6952
Published online Jun 14, 2014. doi: 10.3748/wjg.v20.i22.6946
Diabetes mellitus increases risk for colorectal adenomas in younger patients
Hongha T Vu, Nneka Ufere, Yan Yan, Jean S Wang, Dayna S Early, Jill E Elwing
Hongha T Vu, Nneka Ufere, Yan Yan, Jean S Wang, Dayna S Early, Jill E Elwing, Division of Gastroenterology, Washington University, St. Louis, MO 63110, United States
Author contributions: Vu HT, Wang JS, Early DS and Elwing JEE designed and supervised the study; Vu HT and Ufere N acquired the data; Vu HT, Yan Y and Wang JS analyzed and interpreted the data; Vu HT drafted the manuscript; Vu HT, Ufere N, Yan Y, Wang JS, Early DS and Elwing JE critically revised the manuscript for important intellectual content and approved the final version to be published.
Correspondence to: Hongha T Vu, MD, Division of Gastroenterology, Washington University, 660 South Euclid Avenue, Campus Box 8124, St. Louis, MO 63110, United States. susanvu@gmail.com
Telephone: +1-314-4548201 Fax: +1-314-4545107
Received: October 2, 2013
Revised: December 25, 2013
Accepted: March 7, 2014
Published online: June 14, 2014
Abstract

AIM: To determine if diabetes mellitus (DM) is associated with increased risk of colorectal adenomas in younger subjects.

METHODS: This was a retrospective cohort study of 375 patients undergoing index colonoscopy at a single tertiary care center in the United States. Three cohorts of patients matched for exam date and gender were compared: (1) ages 40-49 years with DM; (2) ages 40-49 years without DM; and (3) ages 50-59 years without DM. Data collected included demographics, co-morbidities, colonoscopy and pathology results. Adenoma detection rates (ADR) were calculated and compared. Conditional logistic regression analysis was performed to determine the association between each cohort and ADR.

RESULTS: One hundred and twenty-five patients ages 40-49 with DM met study eligibility criteria. Patients in the other two cohorts were randomly selected, matching for date of exam and gender. ADR was 14.4% in those ages 40-49 years without DM, 30.4% in those ages 40-49 years with DM, and 32.0% in those ages 50-59 years without DM. Compared to those ages 40-49 years without DM, ADR was higher in those ages 40-49 years with DM (OR = 3.1; 95%CI: 1.5-6.4; P = 0.002) and those ages 50-59 years without DM (OR = 2.9; 95%CI: 1.5-5.6; P = 0.002). There was no difference between the ADR in those ages 40-49 years with DM and those ages 50-59 years without DM (P = 0.83).

CONCLUSION: DM was associated with higher risk of colorectal adenomas in patients ages 40-49 years. These subjects harbored as many adenomas as those at the standard screening age of 50-59 years without DM.

Keywords: Adenoma, Colorectal cancer, Diabetes mellitus, Colonoscopy, Risk factor

Core tip: Diabetes mellitus (DM) is associated with increased risk of colorectal neoplasia. It is unknown if patients with DM should be screened more aggressively. Three cohorts were compared: patients aged 40-49 years with DM, 40-49 years without DM, and 50-59 years without DM. DM was associated with increased risk for developing colorectal adenomas in patients 40-49 years old. This is the first study to specifically examine these differences among patients with or without DM younger than the recommended colorectal cancer screening age of 50 years.