Patients With Complicated Diabetes, Colorectal Cancer May Have Significant Risk of Death From Any Cause

Patients with complicated diabetes and colorectal cancer (CRC) may have a higher likelihood of dying early compared to patients with CRC who do not have diabetes, or have an uncomplicated form of diabetes, according to the results of a study published in the journal CANCER, the peer-reviewed journal of the American Cancer Society.¹

Having complicated diabetes increased the risk of death from any cause by 85% and risk of death from CRC by 41% compared to having uncomplicated or no diabetes; and among patients with complicated diabetes, women and patients with early-stage CRC were most at risk of death from any cause or CRC, according to study findings.^1,2

Previous studies already link diabetes to increased risk of developing CRC. Diabetes results in high levels of insulin and glucose in the blood and increased inflammation, so investigators hypothesize that the severity of the disease can be linked to worse outcomes from CRC.¹

Previous studies already link diabetes to increased risk of developing CRC. Image Credit: © Dr_Microbe - stock.adobe.com

However, there is still not enough data to determine how the severity of diabetes impacts CRC outcomes. Investigators decided to conduct a population-based retrospective cohort study to determine how effectively diabetes severity can predict outcomes in patients who have had curative CRC resection.^1,2

The team evaluated data collected between 2007 and 2015 on 59,202 patients with earlier stage 1 to 3 CRC who had received surgery to remove the tumors. Patients were divided into groups based on diabetes type (complicated versus uncomplicated) or not having diabetes.¹

The study data showed that patients with complicated diabetes experienced worse overall survival (OS; HR, 1.85; 95% CI, 1.78–1.92) than patients without diabetes or patients with uncomplicated diabetes, according to the results of the study.2 Other efficacy endpoints included disease-free survival (DFS), cancer-specific survival (CSS), and time to recurrence. While complicated diabetes was associated with worse DFS (HR, 1.75; 95% CI, 1.69–1.82) and worse CSS (HR, 1.41; 95% CI, 1.33–1.49) outcomes, all patients with diabetes (uncomplicated and complicated) had a worse risk of CRC recurrence post-resection compared to patients without diabetes.²

In fact, any form of diabetes could increase recurrence odds by up to 11%, the study authors note. By the end of the study, 9448 patients had cancer recurrence. Even still, patients with uncomplicated diabetes did not have a significantly greater likelihood of dying from cancer or any cause compared to patients without diabetes.^1,2

“The study suggests that coordinated medical care involving multiple specialists can help prevent diabetes complications, potentially improving long-term CRC oncological outcomes, particularly in women and patients with early-stage cancer,” said study author Kuo‐Liong Chien, MD, PhD, National Taiwan University, in a press release.¹

References

1. Does diabetes affect the survival of individuals with colorectal cancer? Wiley. News Release. October 25, 2023. Accessed October 26, 2023. https://newsroom.wiley.com/press-releases/press-release-details/2023/Does-diabetes-affect-the-survival-of-individuals-with-colorectal-cancer/default.aspx
2. Hsu HY, Chern YJ, Hsu MS, et al. Diabetic severity and oncological outcomes of colorectal cancer following curative resection: A population-based cohort study in Taiwan diabetes and colorectal cancer prognosis. Cancer. 2023;1-10. doi:10.1002/cncr.34975