Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study
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 p...
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| Veröffentlicht in: | PLoS medicine 2020-11, Vol.17 (11), p.e1003431-e1003431 |
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| description | 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.
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.
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. |
| doi_str_mv | 10.1371/journal.pmed.1003431 |
| format | Article |
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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.
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.</description><identifier>ISSN: 1549-1676</identifier><identifier>ISSN: 1549-1277</identifier><identifier>EISSN: 1549-1676</identifier><identifier>DOI: 10.1371/journal.pmed.1003431</identifier><identifier>PMID: 33186354</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Age ; Age Factors ; Aged ; Aged, 80 and over ; Cancer ; Cancer and Oncology ; Cancer och onkologi ; Child ; Child, Preschool ; Clinical Medicine ; Cohort analysis ; Cohort Studies ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - complications ; Colorectal Neoplasms - diagnosis ; Colorectal Neoplasms - epidemiology ; Comorbid patients ; Datasets ; Diabetes ; Diabetes Complications ; Diabetes mellitus ; Diabetes Mellitus - epidemiology ; Diagnosis ; Disease ; Diseases ; Early Detection of Cancer - methods ; Family medical history ; Female ; Humans ; Infant ; Infant, Newborn ; Inflammatory bowel disease ; Klinisk medicin ; Male ; Medical and Health Sciences ; Medical examination ; Medicin och hälsovetenskap ; Medicine and Health Sciences ; Middle Aged ; People and places ; Population ; Registries ; Risk factors ; Sweden - epidemiology ; Young Adult ; Young adults</subject><ispartof>PLoS medicine, 2020-11, Vol.17 (11), p.e1003431-e1003431</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Ali Khan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Ali Khan et al 2020 Ali Khan et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c833t-4e3aa4c32fdb4a81fa2b04838f87fc266dc9eae24b0052cddb7639b7e1cded063</citedby><cites>FETCH-LOGICAL-c833t-4e3aa4c32fdb4a81fa2b04838f87fc266dc9eae24b0052cddb7639b7e1cded063</cites><orcidid>0000-0002-6129-1572 ; 0000-0001-8031-279X ; 0000-0003-4021-134X ; 0000-0001-7228-5015 ; 0000-0003-4919-6641</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7665813/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7665813/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,551,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33186354$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://lup.lub.lu.se/record/927703f2-d71b-4b7e-bfd9-1a1225185905$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><contributor>Shin, Aesun</contributor><creatorcontrib>Ali Khan, Uzair</creatorcontrib><creatorcontrib>Fallah, Mahdi</creatorcontrib><creatorcontrib>Sundquist, Kristina</creatorcontrib><creatorcontrib>Sundquist, Jan</creatorcontrib><creatorcontrib>Brenner, Hermann</creatorcontrib><creatorcontrib>Kharazmi, Elham</creatorcontrib><title>Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study</title><title>PLoS medicine</title><addtitle>PLoS Med</addtitle><description>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.
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.
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epidemiology</subject><subject>Diagnosis</subject><subject>Disease</subject><subject>Diseases</subject><subject>Early Detection of Cancer - methods</subject><subject>Family medical history</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Inflammatory bowel disease</subject><subject>Klinisk medicin</subject><subject>Male</subject><subject>Medical and Health Sciences</subject><subject>Medical examination</subject><subject>Medicin och hälsovetenskap</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>People and places</subject><subject>Population</subject><subject>Registries</subject><subject>Risk factors</subject><subject>Sweden - epidemiology</subject><subject>Young Adult</subject><subject>Young adults</subject><issn>1549-1676</issn><issn>1549-1277</issn><issn>1549-1676</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>D8T</sourceid><sourceid>DOA</sourceid><recordid>eNqVk11v0zAUhiMEYmPwDxBEQkJw0eKv2AkXSNXEx6SJSRtwazn2SeuRxl3sUPbvOV27aUG9AEVHieznvD55j0-WPadkSrmi7y7D0Hemna6W4KaUEC44fZAd0kJUEyqVfHjv-yB7EuMlIawiFXmcHXBOS8kLcZjpcx9_5qHJbWhDDzaZNrems9DnvstXJnnoUszXPi1y500NCWK-hLb1aYjv81l-sQbn4yLvEA3d2jtAqUXoUx7T4K6fZo8a00Z4tnsfZd8_ffx2_GVyevb55Hh2OrEl52kigBsjLGeNq4UpaWNYTUTJy6ZUjWVSOluBASZqQgpmnauV5FWtgFoHjkh-lL3c6q7aEPXOm6iZrCQpKacciZMt4YK51KveL01_rYPx-mYh9HNt-uRtCxqP52hV44ilQhlpJEgrFFTG1IoxQK3TrVZcw2qoR2rtsMKoMXQEXTGlCG-YdorWWmDFum5cpamhjBW0LCpSoNyHXfFDjd20aHlv2pHqeKfzCz0Pv7SSsihv_u3NTqAPVwPEpJc-WuyS6SAMaIOQBA2ThUL01V_ofrN21NygH75rAp5rN6J6JguERMUrpCZ7qDl0gEWGDhqPyyN-uofHx8HS270Jb0cJyCT4neZmiFGfXJz_B_v139mzH2P29T12AaZNixjaYXPd4xgUW9D2IcYemrsGUqI3I3vrtN6MrN6NLKa9uN_8u6TbGeV_AEvgOts</recordid><startdate>20201113</startdate><enddate>20201113</enddate><creator>Ali Khan, Uzair</creator><creator>Fallah, Mahdi</creator><creator>Sundquist, Kristina</creator><creator>Sundquist, Jan</creator><creator>Brenner, Hermann</creator><creator>Kharazmi, Elham</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISN</scope><scope>ISR</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AGCHP</scope><scope>AOWAS</scope><scope>D8T</scope><scope>D95</scope><scope>ZZAVC</scope><scope>DOA</scope><scope>CZK</scope><orcidid>https://orcid.org/0000-0002-6129-1572</orcidid><orcidid>https://orcid.org/0000-0001-8031-279X</orcidid><orcidid>https://orcid.org/0000-0003-4021-134X</orcidid><orcidid>https://orcid.org/0000-0001-7228-5015</orcidid><orcidid>https://orcid.org/0000-0003-4919-6641</orcidid></search><sort><creationdate>20201113</creationdate><title>Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study</title><author>Ali Khan, Uzair ; Fallah, Mahdi ; Sundquist, Kristina ; Sundquist, Jan ; Brenner, Hermann ; Kharazmi, Elham</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c833t-4e3aa4c32fdb4a81fa2b04838f87fc266dc9eae24b0052cddb7639b7e1cded063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer</topic><topic>Cancer and Oncology</topic><topic>Cancer och onkologi</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Clinical Medicine</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Colorectal Neoplasms - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SWEPUB Lunds universitet full text</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Lunds universitet</collection><collection>SwePub Articles full text</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>PLoS Medicine</collection><jtitle>PLoS medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ali Khan, Uzair</au><au>Fallah, Mahdi</au><au>Sundquist, Kristina</au><au>Sundquist, Jan</au><au>Brenner, Hermann</au><au>Kharazmi, Elham</au><au>Shin, Aesun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study</atitle><jtitle>PLoS medicine</jtitle><addtitle>PLoS Med</addtitle><date>2020-11-13</date><risdate>2020</risdate><volume>17</volume><issue>11</issue><spage>e1003431</spage><epage>e1003431</epage><pages>e1003431-e1003431</pages><issn>1549-1676</issn><issn>1549-1277</issn><eissn>1549-1676</eissn><abstract>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.
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.
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33186354</pmid><doi>10.1371/journal.pmed.1003431</doi><orcidid>https://orcid.org/0000-0002-6129-1572</orcidid><orcidid>https://orcid.org/0000-0001-8031-279X</orcidid><orcidid>https://orcid.org/0000-0003-4021-134X</orcidid><orcidid>https://orcid.org/0000-0001-7228-5015</orcidid><orcidid>https://orcid.org/0000-0003-4919-6641</orcidid><oa>free_for_read</oa></addata></record> |
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| issn | 1549-1676 1549-1277 1549-1676 |
| language | eng |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SWEPUB Freely available online; Public Library of Science (PLoS); PubMed Central |
| subjects | Adolescent Adult Age Age Factors Aged Aged, 80 and over Cancer Cancer and Oncology Cancer och onkologi Child Child, Preschool Clinical Medicine Cohort analysis Cohort Studies Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - complications Colorectal Neoplasms - diagnosis Colorectal Neoplasms - epidemiology Comorbid patients Datasets Diabetes Diabetes Complications Diabetes mellitus Diabetes Mellitus - epidemiology Diagnosis Disease Diseases Early Detection of Cancer - methods Family medical history Female Humans Infant Infant, Newborn Inflammatory bowel disease Klinisk medicin Male Medical and Health Sciences Medical examination Medicin och hälsovetenskap Medicine and Health Sciences Middle Aged People and places Population Registries Risk factors Sweden - epidemiology Young Adult Young adults |
| title | Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T20%3A05%3A15IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Risk%20of%20colorectal%20cancer%20in%20patients%20with%20diabetes%20mellitus:%20A%20Swedish%20nationwide%20cohort%20study&rft.jtitle=PLoS%20medicine&rft.au=Ali%20Khan,%20Uzair&rft.date=2020-11-13&rft.volume=17&rft.issue=11&rft.spage=e1003431&rft.epage=e1003431&rft.pages=e1003431-e1003431&rft.issn=1549-1676&rft.eissn=1549-1676&rft_id=info:doi/10.1371/journal.pmed.1003431&rft_dat=%3Cgale_plos_%3EA650814939%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2696081313&rft_id=info:pmid/33186354&rft_galeid=A650814939&rft_doaj_id=oai_doaj_org_article_1fa3290fd0c147a6a6e6c47e9aab722e&rfr_iscdi=true |