Diabetes Severity Associated With Poor Colorectal Cancer Survival

For patients with colorectal cancer (CRC) and diabetes who undergo surgery, the severity of their diabetes is connected to poor survival outcomes — particularly if the patients are female or in the earlier stages of cancer — according to the findings of a recent study.

“Among patients with CRC who undergo curative resection (surgery to remove the patient’s tumor), the severity of the diabetes is inversely correlated with long‐term outcomes, including OS (overall survival; the time that a patient lives following treatment), DFS (disease-free survival; the time that a patient lives following treatment without signs or symptoms of that cancer) and CSS (cancer-specific survival; the time that a patient lives from treatment until dying of that cancer),” researchers wrote in a study published in the journal Cancer.

Utilizing data from 59,202 patients from 2007 to 2015 in the Taiwan Cancer Registry, the team of Taiwanese researchers behind the population-based retrospective study noted in Cancer that their findings “implied that integrated medical care with multiple specialists’ cooperation preventing diabetes from (reaching) complicated status may help patients with CRC avoid poorer survival, especially in women and earlier stages of patients with CRC.”

Read More: Patients, Providers Discuss Co-Management of Cancer And Diabetes

Among patients in the recent Cancer study, patients who had diabetes with complications had an 85% higher risk of death than those without diabetes.

Regarding their finding that female patients with colorectal cancer were at a higher risk for poor survival, researchers wrote that “although the underlying mechanisms behind this result remain incompletely elucidated, the observed disparity in risk between sexes may be attributed to the intricate interplay among sex hormone bioactivity, sex hormone-binding globulin and colorectal cancer proliferation. Further investigation is warranted.”

Likewise, the study authors wrote that “the positive relationship of diabetic severity with poor CRC prognosis may be explained by three potential mechanisms,” which include how diabetes can lead to increased levels of insulin-like growth a hormone accelerating tumor growth, high blood sugar resulting in poor chemotherapy response and the increased oxidative stress and accumulation of genetic mutations that result from the high inflammatory burden caused by diabetes.

Read More: Older Patients With Diabetes May Have 1.5-Fold Increased Risk for Death From Cancer

The connection between diabetes and colon and rectal cancers was established in 1998, according to the Colon Cancer Foundation, while a study published in the journal Diabetologia found that older patients with type 2 diabetes had a 1.5-fold increased risk of mortality from colorectal, pancreatic, endometrial and liver cancers and research in the Journal of Diabetes found that women with type 2 diabetes had a 62% higher risk of developing cancer than the general population, and men a 34% higher risk.

Studies have also demonstrated the link between long-term increased insulin levels and increased risk of colorectal cancer and other cancer types, as Dr. Zoe Quandt, an endocrinologist at the University of California San Francisco (UCSF) Medical Center, previously told CURE®.

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