Diminishing differences in treatment between patients with colorectal cancer with and without diabetes: a population‐based study

Zanders, M.M.J.; Steenbergen, L.N. van; Haak, Harm R.; Rutten, H.J.T.; Pruijt, J.F.M.; Poortmans, Philip; Lemmens, Valery; Poll‐Franse, Lonneke V. van de

doi:10.1111/dme.12253

Cited by 17 publications

(8 citation statements)

References 29 publications

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“…Respondents who reported having diabetes also reported the number of times in the past year they had seen a health professional for their diabetes. Selection of covariates was based on reports in scientific literature (8,11,19,20). …”

Section: Methodsmentioning

confidence: 99%

Diabetes Status and Being Up-to-Date on Colorectal Cancer Screening, 2012 Behavioral Risk Factor Surveillance System

Porter¹,

Eberth²,

Samson³

et al. 2016

Prev. Chronic Dis.

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IntroductionAlthough screening rates for colorectal cancer are increasing, 22 million Americans are not up-to-date with recommendations. People with diabetes are an important and rapidly growing group at increased risk for colorectal cancer. Screening status and predictors of being up-to-date on screening are largely unknown in this population.MethodsThis study used logistic regression modeling and data from the 2012 Behavioral Risk Factor Surveillance System to examine the association between diabetes and colorectal cancer screening predictors with being up-to-date on colorectal cancer screening according to criteria of the US Preventive Services Task Force for adults aged 50 or older. State prevalence rates of up-to-date colorectal cancer screening were also calculated and mapped.ResultsThe prevalence of being up-to-date with colorectal cancer screening for all respondents aged 50 or older was 65.6%; for respondents with diabetes, the rate was 69.2%. Respondents with diabetes were 22% more likely to be up-to-date on colorectal cancer screening than those without diabetes. Among those with diabetes, having a routine checkup within the previous year significantly increased the odds of being up-to-date on colorectal cancer screening (odds ratio, 1.90). Other factors such as age, income, education, race/ethnicity, insurance status, and history of cancer were also associated with up-to-date status.ConclusionRegardless of diabetes status, people who had a routine checkup within the past year were more likely to be up-to-date than people who had not. Among people with diabetes, the duration between routine checkups may be of greater importance than the frequency of diabetes-related doctor visits. Continued efforts should be made to ensure that routine care visits occur regularly to address the preventive health needs of patients with and patients without diabetes.

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Section: Methodsmentioning

confidence: 99%

Diabetes Status and Being Up-to-Date on Colorectal Cancer Screening, 2012 Behavioral Risk Factor Surveillance System

Porter¹,

Eberth²,

Samson³

et al. 2016

Prev. Chronic Dis.

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“…Our meta-analysis of studies on the associations of diabetes ( n = 5), 24,34,37,38,48 myocardial infarction ( n = 2), 39,48 heart failure ( n = 4), 24,37,39,48 stroke ( n = 2), 38,48 renal disease ( n = 2), 34,48 COPD ( n = 6), 22,24,37–39,48 and dementia ( n = 5) 14,21,30,34,39 with chemotherapy administration is shown in Figure 4. Patients having any of these diseases received chemotherapy less often, but the associations with myocardial infarction and renal disease were not statistically significant.…”

Section: Resultsmentioning

confidence: 99%

The association of comorbidities with administration of adjuvant chemotherapy in stage III colon cancer patients: a systematic review and meta-analysis

et al. 2021

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Background: Chemotherapy is an established treatment for stage III colon cancer cases. Older age is known to be associated with less chemotherapy use in these patients, but there might be other relevant factors besides age that influence treatment administration. We summarized evidence on associations between comorbidity and adjuvant chemotherapy administration in stage III colon cancer patients in a systematic review and meta-analysis. Methods: We searched the PubMed and Web of Science databases up to 2 June 2020 for studies on comorbidities and chemotherapy use in patients with stage III colon cancer. Summary odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using random-effects models. Subgroup analyses according to year of colon cancer diagnosis, timing of comorbidity assessment, and geographical region were also conducted. Results: Thirty-three studies were included in this review, including 219,406 stage III colon cancer patients overall. Chemotherapy administration was 60.9% (95% CI: 56.9% to 64.9%), increasing from 57.1% before 2001 to 66.3% after 2010. There were inverse associations between comorbidities and chemotherapy administration. Compared with patients with Charlson comorbidity score 0, those with scores 1 (OR = 0.79, 95% CI = 0.72–0.87) and 2+ (OR = 0.49, 95% CI = 0.42–0.56) received chemotherapy less often. Among comorbidities, the strongest predictors of chemotherapy non-use were dementia (OR = 0.37, 95% CI = 0.33–0.54), followed by heart failure (OR = 0.44, 95% CI = 0.28–0.70) and stroke (OR = 0.56, 95% CI = 0.38–0.81). Conclusions: Merely 60% of stage III colon cancer patients receive chemotherapy. Comorbidities are strong predictors of chemotherapy non-use, but the association differs by comorbid condition and is strongest with dementia. Given the survival disadvantage of colon cancer patients with comorbidities, further evidence on the risk–benefit ratio of chemotherapy according to the type and severity of comorbidity and on the extent to which the survival disadvantage of comorbidity is explained by less use or lower tolerability of chemotherapy is needed to foster personalized medical care in these patients.

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“…Information on comorbidity was not available in our study, but the Moroccan group is known to suffer more often from chronic diseases like diabetes [22] and hypertension [23]. Noticeably, CRC patients with diabetes have been shown to receive less often chemotherapy than non-diabetes patients [24]. Therefore, the effect of adjuvant chemotherapy on the excess mortality rate of the Moroccan CC patients in our study might be standing for a higher comorbidity within this group, which would explain the higher 5-year all-cause mortality, without having any significant effect on the 5-year colorectal cancer-specific mortality.…”

Section: Discussionmentioning

confidence: 99%

Ethnic differences in colon cancer care in the Netherlands: a nationwide registry-based study

et al. 2017

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BackgroundEthnic differences in colon cancer (CC) care were shown in the United States, but results are not directly applicable to European countries due to fundamental healthcare system differences. This is the first study addressing ethnic differences in treatment and survival for CC in the Netherlands.MethodsData of 101,882 patients diagnosed with CC in 1996–2011 were selected from the Netherlands Cancer Registry and linked to databases from Statistics Netherlands. Ethnic differences in lymph node (LN) evaluation, anastomotic leakage and adjuvant chemotherapy were analysed using stepwise logistic regression models. Stepwise Cox regression was used to examine the influence of ethnic differences in adjuvant chemotherapy on 5-year all-cause and colorectal cancer-specific survival.ResultsAdequate LN evaluation was significantly more likely for patients from ‘other Western’ countries than for the Dutch (OR 1.09; 95% CI 1.01–1.16). ‘Other Western’ patients had a significantly higher risk of anastomotic leakage after resection (OR 1.24; 95% CI 1.05–1.47). Patients of Moroccan origin were significantly less likely to receive adjuvant chemotherapy (OR 0.27; 95% CI 0.13–0.59). Ethnic differences were not fully explained by differences in socioeconomic and hospital-related characteristics. The higher 5-year all-cause mortality of Moroccan patients (HR 1.64; 95% CI 1.03–2.61) was statistically explained by differences in adjuvant chemotherapy receipt.ConclusionThese results suggest the presence of ethnic inequalities in CC care in the Netherlands. We recommend further analysis of the role of comorbidity, communication in patient-provider interaction and patients’ health literacy when looking at ethnic differences in treatment for CC.

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Diminishing differences in treatment between patients with colorectal cancer with and without diabetes: a population‐based study

Abstract: Although the administration of chemotherapy and radiotherapy increased between 1995 and 2010 in patients with colorectal cancer with and without diabetes, patients with colorectal cancer with diabetes continue to receive chemotherapy less frequently than those without diabetes.

Cited by 17 publications

References 29 publications

Diabetes Status and Being Up-to-Date on Colorectal Cancer Screening, 2012 Behavioral Risk Factor Surveillance System

Diabetes Status and Being Up-to-Date on Colorectal Cancer Screening, 2012 Behavioral Risk Factor Surveillance System

The association of comorbidities with administration of adjuvant chemotherapy in stage III colon cancer patients: a systematic review and meta-analysis

Ethnic differences in colon cancer care in the Netherlands: a nationwide registry-based study

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