Diabetes Mellitus and Age are Risk Factors of Interval Colon Cancer: A Case-Control Study

Abstract

Background and Aims: Interval colorectal cancer (CRC) is largely related to a poor endoscopic performance or different biology in the development of the polyp. However, patient-related factors were less investigated for their association with interval cancer. We thus evaluated tumor and patient characteristics as predictors of interval cancer in a population from Israel. Methods: In this retrospective study, patients that were diagnosed with colon cancer in our institution and had 2 colonoscopies were included. Demographic parameters and tumor characteristics were compared between 84 cases with interval cancer, occurring 1–10 years after a negative colonoscopy, and 983 patients with primary CRC. In addition, patient-related features, including diabetes and diverticulosis, were compared between 51 patients with interval cancer after negative colonoscopy and 255 controls with no cancer and a previous negative colonoscopy. Results: Compared to “positive” controls with primary cancer, patients with interval cancer were older (age 71.3 vs. 67.6, p = 0.003), had proximal tumor location (57 vs. 34%, p < 0.001) and non-advanced (0–2) tumor staging (78.5 vs. 64.8%, p = 0.014). Compared with ­“negative” healthy controls, cases with interval cancer had only higher prevalence of diabetes (31 vs. 15%, p = 0.002). No significant differences were seen between patients with interval cancer occurring < 3 years and after 3–10 years. Conclusions: Patients with Interval cancer tend to be older and have diabetes. These patient groups should be more carefully or more frequently screened for pre-malignant lesions.

Utility of KRAS Gene and Clinicopathological Features in the Assessment of the Risk of Type 2 Diabetes in the Etiology of Colon Cancer

“…This indicates that diabetic patients are at a higher risk of developing colorectal cancer, thus are in higher need for controlled colonoscopy. 16,17 However, these facts may suggest further considerations when assessing diabetic patients with colon cancer in terms of clinical features, treatment, and prognosis.…”

Characteristics and Risk Factors of Interval Colorectal Advanced Adenomas after Negative Index Colonoscopy

“…27.7% vs 15.3%, 40.2% vs 26.6%, 25.9% vs 16.1%,14.3% vs 7.8%, respectively; all p < 0.05). Further analysis of colonoscopy characteristics found that the bowel preparation of diagnostic colonoscopy in I-CRAA is better (52.7% vs 23.7%, p < 0.05), the probability of nding a diverticulum is greater (5.4% vs 1.8%, p < 0.05), and the ADR of the diagnostic colonoscopy is higher (29.5% vs 20.9%, p < 0.05) compared with Sp-CRAA.…”

“…There are su cient evidences to prove that diabetes is an independent risk factor for I-CRC. The study of Laish et al also found that cases with I-CRC had higher prevalence of diabetes [13,14] . Our study reveals the relationship between diabetes, diverticulosis and I-CRAA for the rst time.…”

Risk factor analysis of malignant adenomas detected during colonoscopy

“…Many studies have shown that age is associated with the development of CRC ( 35 ). Some studies have found that patients <50 years of age are more likely to have distal CRC, while older patients are more likely to have proximal CRC ( 36 ).…”