Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study

Background Colorectal cancer (CRC) incidence is increasing among young adults below screening age, despite the effectiveness of screening in older populations. Individuals with diabetes mellitus are at increased risk of early-onset CRC. We aimed to determine how many years earlier than the general population patients with diabetes with/without family history of CRC reach the threshold risk at which CRC screening is recommended to the general population. Methods and findings A nationwide cohort study (follow-up:1964–2015) involving all Swedish residents born after 1931 and their parents was carried out using record linkage of Swedish Population Register, Cancer Registry, National Patient Register, and Multi-Generation Register. Of 12,614,256 individuals who were followed between 1964 and 2015 (51% men; age range at baseline 0–107 years), 162,226 developed CRC, and 559,375 developed diabetes. Age-specific 10-year cumulative risk curves were used to draw conclusions about how many years earlier patients with diabetes reach the 10-year cumulative risks of CRC in 50-year-old men and women (most common age of first screening), which were 0.44% and 0.41%, respectively. Diabetic patients attained the screening level of CRC risk earlier than the general Swedish population. Men with diabetes reached 0.44% risk at age 45 (5 years earlier than the recommended age of screening). In women with diabetes, the risk advancement was 4 years. Risk was more pronounced for those with additional family history of CRC (12–21 years earlier depending on sex and benchmark starting age of screening). The study limitations include lack of detailed information on diabetes type, lifestyle factors, and colonoscopy data. Conclusions Using high-quality registers, this study is, to our knowledge, the first one that provides novel evidence-based information for risk-adapted starting ages of CRC screening for patients with diabetes, who are at higher risk of early-onset CRC than the general population.

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Risk factors for early-onset colorectal cancer in China.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.10542 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 10542-10542

Author(s):

Zhe Pan ◽

Junfeng Huang ◽

Mingkai Huang ◽

Zhiyuan Yao ◽

Jiongqiang Huang ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Cohort Study ◽

Family History ◽

Early Onset ◽

Cancer Site ◽

Family History Of Cancer ◽

History Of ◽

Early Onset Colorectal Cancer ◽

History Of Cancer

10542 Background: The incidence of colorectal cancer among persons aged < 50 years (early-onset colorectal cancer, EOCRC) has increased since the early 1990s. However, the risk factors contributing to this trend remain largely unknown. Methods: We conducted a retrospective study of participants who were aged < 50 years and without a previous cancer history, using the China Kadoorie Biobank cohort study. We analyzed data related to demographics, lifestyle habits, family history, and comorbidities of EOCRC cases with participants without colorectal cancer in this age group (controls). Univariate and multivariate-adjusted cox regression models were used to estimate the associations with risk factors. Results: We identified 225 EOCRC cases and 88842 controls that include the final analyses. Of the 225 EOCRC patients, 105 (46.7%) were colon cancers and 120 (53.3%) were rectum cancers. EOCRC cases were older, have more intake of fish and eggs, have higher BMIs, diabetes, and family history of cancer compared with controls (P < 0.05). After adjustment for potential confounding factors, increasing age (HR 2.18, 95%CI 2.05-2.31), BMI (HR 1.06, 95%CI 1.01-1.11), family history of cancer (HR 1.41, 95%CI 1.00-1.98), and more intake of fish (HR 1.54, 95%CI 1.09-2.19) were significantly associated with a higher risk of EOCRC. In sensitivity analyses stratified by cancer site (colon and rectum), the results remained consistent. Conclusions: Based on the large Chinese cohort study, we found increasing age, higher BMI or obesity, family history of cancer, and more intake of fish were independent risk factors for EOCRC. Further studies are needed to identify factors that cause the increasing incidence of EOCRC in China and other countries, and explore the potential mechanism behind.[Table: see text]

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Familial colorectal cancer risk in half siblings and siblings: nationwide cohort study

BMJ ◽

10.1136/bmj.l803 ◽

2019 ◽

pp. l803 ◽

Cited By ~ 6

Author(s):

Yu Tian ◽

Elham Kharazmi ◽

Kristina Sundquist ◽

Jan Sundquist ◽

Hermann Brenner ◽

...

Keyword(s):

Colorectal Cancer ◽

Cohort Study ◽

Family History ◽

Cancer Risk ◽

Confidence Interval ◽

Cumulative Risk ◽

Degree Relative ◽

History Of ◽

Half Sibling ◽

Second Degree

AbstractObjectiveTo explore the risk of colorectal cancer in family members of patients with colorectal cancer, with an emphasis on subtypes of second degree relatives, especially half siblings, which were lacking in the literature.DesignAmbidirectional cohort study.SettingNationwide Swedish Family Cancer Data (record linkage).ParticipantsAll people residing in Sweden and born after 1931, with their biological parents, totalling >16 million individuals (follow-up: 1958-2015); of those with clear genealogy, 173 796 developed colorectal cancer.Main outcome measuresLifetime (0-79 years) cumulative risk and standardised incidence ratio of colorectal cancer among first degree relatives and second degree relatives.ResultsThe overall lifetime cumulative risk of colorectal cancer in siblings of patients was 7%, which represents a 1.7-fold (95% confidence interval 1.6 to 1.7; n=2089) increase over the risk in those without any family history of colorectal cancer. A similarly increased lifetime cumulative risk (6%) was found among half siblings (standardised incidence ratio 1.5, 95% confidence interval 1.3 to 1.8; n=140). The risk in people with colorectal cancer in both a parent and a half sibling (standardised incidence ratio 3.6, 2.4 to 5.0; n=32) was close to the risk in those with both an affected parent and an affected sibling (2.7, 2.4 to 3.0; n=396). Family history of colorectal cancer in only one second degree relative other than a half sibling (without any affected first degree relatives), such as a grandparent, uncle, or aunt, showed minor association with the risk of colorectal cancer.ConclusionFamily history of colorectal cancer in half siblings is similarly associated with colorectal cancer risk to that in siblings. The increase in risk of colorectal cancer among people with one affected second degree relative was negligible, except for half siblings, but the risk was substantially increased for a combination of family history in one affected second degree relative and an affected first degree relative (or even another second degree relative). These evidence based findings provide novel information to help to identify people at high risk with a family history of colorectal cancer that can potentially be used for risk adapted screening.

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A positive family history of cancer or lifestyle factors may not explain the high incidence of early-onset colorectal cancer in India

Colorectal Cancer ◽

10.2217/crc.14.31 ◽

2014 ◽

Vol 3 (5) ◽

pp. 409-416

Author(s):

Ratheesh Raman ◽

Viswakalyan Kotapalli ◽

Mohana Vamsy ◽

Sujit C Patnaik ◽

Mukta Srinivasulu ◽

...

Keyword(s):

Colorectal Cancer ◽

Family History ◽

Early Onset ◽

Positive Family History ◽

Lifestyle Factors ◽

Family History Of Cancer ◽

High Incidence ◽

History Of ◽

Early Onset Colorectal Cancer ◽

History Of Cancer

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A64 REVIEW OF PATIENTS REFERRED TO THE DIVISION OF DIGESTIVE CARE AND ENDOSCOPY AT DALHOUSIE UNIVERSITY FOR COLORECTAL CANCER SCREENING BASED ON A FAMILY HISTORY OF COLORECTAL CANCER: HOW MANY UNDERWENT COLONOSCOPY?

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.062 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 23-25

Author(s):

M Miles

Keyword(s):

Colorectal Cancer ◽

Family History ◽

High Risk ◽

Average Risk ◽

Cross Sectional ◽

Crc Screening ◽

Increased Risk ◽

Fit Testing ◽

Quality Assessment Study ◽

History Of

Abstract Background Nova Scotia has provincial colorectal cancer (CRC) screening for asymptomatic, average risk individuals age 50–74 using fecal immunochemical testing (FIT) every 2 years. However, individuals with 1 or more first degree relatives (FDR) diagnosed with CRC by age 60 have a 2–4 fold increased risk for developing CRC. For these high risk individuals, current guidelines recommend CRC screening with colonoscopy rather than FIT testing. Annually, the Division of Digestive Care & Endoscopy (DCE) at Dalhousie University receives many referrals for patients with a family history of CRC but the percentage of patients who require this procedure is unclear. Aims The objectives of this quality assessment study were to review patients referred to DCE for a family history of CRC to (1) better understand the indication for referral; and (2) determine the percentage of patients undergoing colonoscopy Methods This was a retrospective cross sectional review of a prospectively updated database. The study population was patients referred to DCE from 2012–2019 based on a family history of CRC, as indicated on the referral. Family history of CRC was defined as 1 or more FDRs diagnosed with CRC. High risk patients were those with 2 or more FDRs with CRC or 1 FDR diagnosed by age 60. All patients were reviewed by a single gastroenterologist in clinic. Results A total of 107 referrals from 2012–2019 were reviewed. Of patients age 50 or older, 51/78 (65.4%) had performed at least 1 FIT. The indications for referral were 2 or more FDR diagnosed with CRC for 6/107 (5.6%) patients, 1 FDR diagnosed with CRC by age 60 for 37/107 patients (34.6%) and 1 FDR diagnosed with CRC over age 60 for 33/107 patients (30.8%). The remaining 31/107 patients (29.0%) had no FDR with CRC. Of the 43/107 patients (40.2%) considered high risk based on family history alone, 34/43 (79.1%) underwent colonoscopy and 8/43 (18.6%) opted for FIT testing. Of the 64/107 patients (59.8%) considered average risk based on family history alone, 26/64 (40.6%) had another indication for colonoscopy and 35/64 (54.7%) resumed FIT testing. Conclusions The majority of patients (71.0%) referred to the DCE for a family history of CRC had at least 1 FDR with CRC. Just over half of patients (55.1%) referred to the DCE for a family history of CRC underwent colonoscopy. Strategies to improve the referral process by better capturing high risk individuals are needed. Funding Agencies None

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Family history of venous thromboembolism and mortality after venous thromboembolism: a Swedish population-based cohort study

Journal of Thrombosis and Thrombolysis ◽

10.1007/s11239-016-1464-y ◽

2016 ◽

Vol 43 (4) ◽

pp. 469-475 ◽

Cited By ~ 2

Author(s):

Bengt Zöller ◽

Mirnabi Pirouzifard ◽

Jan Sundquist ◽

Kristina Sundquist

Keyword(s):

Cohort Study ◽

Venous Thromboembolism ◽

Family History ◽

Population Based ◽

Swedish Population ◽

History Of

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Family history of colorectal cancer and survival: a Swedish population‐based study

Journal of Internal Medicine ◽

10.1111/joim.13036 ◽

2020 ◽

Vol 287 (6) ◽

pp. 723-733 ◽

Cited By ~ 1

Author(s):

F. Pesola ◽

S. Eloranta ◽

A. Martling ◽

D. Saraste ◽

K. E. Smedby

Keyword(s):

Colorectal Cancer ◽

Family History ◽

Population Based ◽

Swedish Population ◽

Population Based Study ◽

History Of

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Association Analysis Between Different Diabetic Family History and Gender with Diagnosed Age of Type 2 Diabetes Mellitus: A Cross-sectional Study in Tianjin, China

10.21203/rs.3.rs-126128/v1 ◽

2020 ◽

Author(s):

Zhaohu Hao ◽

Xiao Huang ◽

Xiaohui Liu ◽

Rong Xu ◽

JunXin Yao ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Logistic Regression ◽

Regression Analysis ◽

Family History ◽

Early Onset ◽

History Of ◽

And Gender

Abstract Background: To investigate the correlation between different diabetic family history and gender with diagnosed age of type 2 diabetes mellitus(T2DM).Methods: To register the newly diagnosed T2DM patients who were admitted to the diabetes identification center of our hospital from October 2017 to June 2020. According to whether the age of diagnosis is more than 40 years old, patients were divided into two groups (early-onset T2DM and late-onset T2DM). In the study,the DM family history was divided into five types: (a)Father DM:Only the father had diabetes in both parents;(b)Mother DM:Only the mother had diabetes in both parents;(c)Both parents DM,Both parents have DM;(d)other family history of DM (without father or mother with DM) and (e)without family history of DM.The diagnosed age with different genders and diabetic family history is compared.Multivariate logistic regression analysis was used to investigate the correlation factors of early-onset T2DM.Results: 3725 patients completed the survey. There were 589 patients (15.8%) with early-onset T2DM, and2469 patients (66.3%) had diabetic family history. The T2DM diagnosed age in male was lower than that in female(51.7 ± 11.2vs54.0 ± 10.2,t = -6.283, p<0.001).The result was also reflected in different DM family history(with Both parents DM,46.7±11.1vs48.5±10.3,t = -1.105, p=0.271;with Father DM,46.8±10.8vs49.8±11.3,t=-2.825,p=0.005;with Mother DM,50.4±10.6vs52.3±10.2,t=-2.342,p=0.019;with other DM familiy history,54.0±10.8vs55.7±9.5,t=-2.652,p=0.008;with NO DM familiy history,53.0±11.0vs55.9±9.3,t=-4.738,p<0.001).T2DM diagnosed age with both parents DM(47.5±11.0) and father DM(47.9±11.1) family history<that with mother DM family history(51.1±10.5) < that with other DM family history(54.7±10.3) and no DM family history(54.1±10.5).Logistic regression analysis indicated that gender(OR2.124,p<0.001), father DM history(OR2.7,p<0.001), mother DM history(OR1.548,p=0.001), both parents DM(OR2.844,p<0.001),BMI(OR1.106,p<0.001) and drinking history(OR0.682,p=0.002) were correlated with early-onset T2DM.Conclusion: Patients with early-onset T2DM tend to have more obvious DM family history in China. This survey shows that the parent DM family history especially father diabetes family history, male patients are diagnosed T2DM earlier.Drinking history was negatively correlated with the early-onset T2DM in male patients.We need more aggressive screening for diabetes in children with a family history of diabetes, especially in men.

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