COMMENTARY

Diabetes in CRC Survivors: How Big Is the Risk?

David J. Kerr, CBE, MD, DSc, FRCP, FMedSci

Disclosures

July 08, 2016

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Hello. I'm David Kerr. I'm professor of cancer medicine from the University of Oxford. Apologies for looking a little older, tireder, and more rundown than usual. I woke up at 3 o'clock this morning and took an early flight back from Venice. Nevertheless, on the way I picked up an interesting article in the Journal of the National Cancer Institute, produced by Dr Simron Singh and colleagues[1] from Toronto, who performed a population-based registry study looking at incidence of diabetes in colorectal cancer patients. Why is that interesting? Because we know that patients with diabetes have a higher instance of colorectal cancer.[2] What if we switched the question around and asked: Do patients with colorectal cancer have a higher incidence of diabetes?

They had a study population of about 40,000 patients with colorectal cancer, and they found approximately 200,000 age- and gender-matched controls. They found that in the first year after the diagnosis of colorectal cancer, those patients had a hazard ratio of 1.53—that is, they had a 53% higher incidence of diabetes. In the general population, their tradition of follow-up was around 5 years. If you follow through to year 5, there is still an elevated risk of about an additional 20% of those individuals developing diabetes.

This is something that we need to consider in the community and in the population of colorectal cancer survivors that we look after. We should perhaps wonder about whether to recommend screening, or at least give advice about avoiding diabetes through lifestyle changes and alterations.

This was an interesting study. It posed an interesting question by turning one question on its head to answer something that seems clinically relevant to me. Certainly, in our clinical practice, I am going to give our colorectal cancer survivors advice about diabetes avoidance, and I'm going to consult with a diabetologist to see whether we think it would be worthwhile doing more formal screening.

As always, thanks for listening. For the time being, Medscapers, ahoy and over and out. Thank you very much.

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