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Diabetes mellitus increases risk for colorectal adenomas in younger patients
Hongha T Vu1, Nneka Ufere1, Yan Yan1
1Hongha 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.
Insights
Diabetes mellitus (DM) increases colorectal adenoma risk in patients aged 40-49, presenting a risk similar to individuals 10 years older. Early screening may be warranted for younger patients with diabetes.
Area of Science:
- Gastroenterology
- Endocrinology
- Oncology
Background:
- Colorectal adenomas are precursors to colorectal cancer.
- Diabetes mellitus (DM) is a growing public health concern.
- The association between DM and colorectal adenomas in younger populations is not well-established.
Purpose of the Study:
- To investigate the association between diabetes mellitus (DM) and the risk of colorectal adenomas in patients aged 40-49 years.
- To compare adenoma detection rates (ADR) in younger patients with and without DM to older patients without DM.
Main Methods:
- Retrospective cohort study of 375 patients undergoing colonoscopy.
- Comparison of three matched cohorts: 40-49 years with DM, 40-49 years without DM, and 50-59 years without DM.
- Conditional logistic regression analysis to assess the association between DM and ADR.
Main Results:
- Patients aged 40-49 with DM had a significantly higher ADR (30.4%) compared to those without DM (14.4%).
- The ADR in patients aged 40-49 with DM was comparable to that of patients aged 50-59 without DM (32.0%).
- DM was associated with a 3.1-fold increased risk of colorectal adenomas in the 40-49 age group.
Conclusions:
- Diabetes mellitus is associated with an elevated risk of colorectal adenomas in individuals aged 40-49.
- Younger patients with DM exhibit an adenoma burden similar to individuals at the standard screening age (50-59) without DM.
- These findings suggest a potential need for earlier colorectal cancer screening in younger patients diagnosed with diabetes.
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.
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