Evidence map›Paper›PMID 21912438›Full record

SynthesisThe American journal of gastroenterology2011

Is diabetes mellitus an independent risk factor for colon cancer and rectal cancer?

Hiroki Yuhara, Craig Steinmaus, Stephanie E Cohen, Douglas A Corley, Yoshihiro Tei, Patricia A Buffler

Abstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The American journal of gastroenterology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 191 papers, 30 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
191citing papers in PubMed, 30 pooled it
10.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

191 citing papers in PubMed, 30 syntheses or guidelines pooled it, 370 citations in OpenAlex.

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131 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Hiroki YuharaDivision of Epidemiology, Berkeley School of Public Health, University of California, Berkeley, California 94720-7358, USA. hirokiyuhara@gmail.com
Craig Steinmaus
Stephanie E Cohen
Douglas A Corley
Yoshihiro Tei
Patricia A Buffler
Berkeley Public Health Division · USEbina General Hospital · JPKaiser Permanente San Francisco Medical Center · USUniversity of California, San Francisco · US

Funding

Ujima Mentoring ProgramP30MH062246 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MALLORY O JOHNSON · 2001 to 2026
$57.4M
TRAINEESHIPS IN AIDS PREVENTION STUDIEST32MH019105 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Carol Suzanne Camlin, Glenn-Milo Santos · 1989 to 2026
$15.3M
NIMH NIH HHS P30 MH062246NIMH NIH HHS T32 MH019105
6 · The paper itself

Abstract

objectivesDiabetes mellitus (DM) has been associated with an increased risk of colorectal cancer (CRC). The American College of Gastroenterology Guidelines for Colorectal Cancer Screening 2008 recommend that clinicians be aware of an increased CRC risk in patients with smoking and obesity, but do not highlight the increase in CRC risk in patients with DM. To provide an updated quantitative assessment of the association of DM with colon cancer (CC) and rectal cancer (RC), we conducted a meta-analysis of case-control and cohort studies. We also evaluated whether the association varied by sex, and assessed potential confounders including obesity, smoking, and exercise.

methodsWe identified studies by searching the EMBASE and MEDLINE databases (from inception through 31 December 2009) and by searching bibliographies of relevant articles. Summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated with fixed- and random-effects models. Several subgroup analyses were performed to explore potential study heterogeneity and bias.

resultsDM was associated with an increased risk of CC (summary RR 1.38, 95% CI 1.26-1.51; n=14 studies) and RC (summary RR 1.20, 95% CI 1.09-1.31; n=12 studies). The association remained when we limited the meta-analysis to studies that either controlled for smoking and obesity, or for smoking, obesity, and physical exercise. DM was associated with an increased risk of CC for both men (summary RR 1.43, 95% CI 1.30-1.57; n=11 studies) and women (summary RR 1.35, 95% CI 1.14-1.53; n=10 studies). For RC, there was a significant association between DM and cancer risk for men (summary RR 1.22, 95% CI 1.07-1.40; n=8 studies), but not for women (summary RR 1.09, 95% CI=0.99-1.19; n=8 studies).

conclusionsThese data suggest that DM is an independent risk factor for colon and rectal cancer. Although these findings are based on observational epidemiological studies that have inherent limitations due to diagnostic bias and confounding, subgroup analyses confirmed the consistency of our findings across study type and population. This information can inform risk models and specialty society CRC screening guidelines.

Indexed as

Body Mass IndexCase-Control StudiesCohort StudiesColonic NeoplasmsConfidence IntervalsDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2ExerciseFemaleHumansMaleObesityRectal NeoplasmsRisk AssessmentSmoking

Identifiers

PMID21912438
PMCPMC3741453
OpenAlexW2005903558

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.