Dataset Information

Increased mortality for colorectal cancer patients with preexisting diabetes mellitus: an updated meta-analysis.

ABSTRACT:

Background

Although the preexisting diabetes mellitus (DM) is known to have a high risk for death in many cancers, its impact on the mortality for the colorectal cancer (CRC) patients is still uncertain. In this study, we conducted a meta-analysis to explore an association of DM with the survival for the CRC patients.

Materials and methods

We made a relative data search from the public available databases including Medline and Embase with a cutoff date to Jan 31, 2017. Pooled hazard ratios (HRs) were calculated using either a fixed or random effect model. Trim and fill analysis was conducted to test and adjust for publication bias. Subgroup analyses were also performed for overall survival and all-cause mortality when stratified by tumor stage, geographical region, duration of follow-up, gender and subsite of cancer.

Results

Twenty-one eligible cohorts including 1,025,034 patients were identified and included in this meta-analysis review. The sample size for each analysis was ranged from 207 to 771,297 patients. It is revealed that with the preexisting DM, the CRC patients had a significantly increased all-cause mortality (pooled adjusted HR: 1.23; 95% CI: 1.11, 1.37) and decreased overall survival (pooled adjusted HR: 1.25, 95% CI: 1.19-1.31). But no difference was found for adjusted cancer-specific survival for the CRC patients with the preexisting DM compared with subjects without DM. These associations almost remained consistent after trim and fill adjustment and across those outcomes when stratified by site of cancer, tumor stage, population geography, study design, duration of follow-up, data resource or gender.

Conclusions

This meta-analysis review indicates that preexisting diabetes mellitus in CRC patients is severely associated with the worse overall survival but not with cancer-specific survival.

SUBMITTER: Li J

PROVIDER: S-EPMC5617522 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Publications

Increased mortality for colorectal cancer patients with preexisting diabetes mellitus: an updated meta-analysis.

Li Jingtao J Liu Jixi J Gao Chun C Liu Fang F Zhao Hongchuan H

Oncotarget 20170804 37

<h4>Background</h4>Although the preexisting diabetes mellitus (DM) is known to have a high risk for death in many cancers, its impact on the mortality for the colorectal cancer (CRC) patients is still uncertain. In this study, we conducted a meta-analysis to explore an association of DM with the survival for the CRC patients.<h4>Materials and methods</h4>We made a relative data search from the public available databases including Medline and Embase with a cutoff date to Jan 31, 2017. Pooled haza ...[more]

PMID: 28977962

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Project description:ContextDepression and diabetes mellitus have been associated with an increased risk of all-cause and cardiovascular disease (CVD) mortality. However, data evaluating the joint effects of these 2 conditions on mortality are sparse.ObjectivesTo evaluate the individual and joint effects of depression and diabetes on all-cause and CVD mortality rate.DesignProspective cohort study.SettingThe 11 states of the Nurses' Health Study.ParticipantsA total of 78 282 women who participated in the Nurses' Health Study aged 54 to 79 years at baseline in 2000 were followed up until 2006. Depression was defined as having self-reported diagnosed depression, treatment with antidepressant medications, or a score indicating severe depressive symptoms (ie, a 5-item Mental Health Index score ≤52). Self-reported type 2 diabetes was confirmed using a supplementary questionnaire.Main outcome measuresAll-cause and CVD-specific mortality rate.ResultsDuring 6 years of follow-up (433 066 person-years), 4654 deaths were documented, including 979 deaths from CVD. Compared with participants without either condition, the age-adjusted relative risks (RRs) (95% confidence interval) for all-cause mortality were 1.76 (1.64-1.89) for women with depression only, 1.71 (1.54-1.89) for individuals with diabetes only, and 3.11 (2.70-3.58) for women with both conditions. The corresponding age-adjusted RRs of CVD mortality were 1.81 (1.54-2.13), 2.67 (2.20-3.23), and 5.38 (4.19-6.91), respectively. These associations were attenuated after multivariate adjustment for other demographic variables, body mass index, smoking status, alcohol intake, physical activity, and major comorbidities (including hypertension, hypercholesterolemia, heart diseases, stroke, and cancer) but remained significant, with the highest RRs for all-cause and CVD mortality found in those with both conditions (2.07 [1.79-2.40] and 2.72 [2.09-3.54], respectively). Furthermore, the combination of depression with a long duration of diabetes mellitus (ie, >10 years) or insulin therapy was associated with a particularly higher risk of CVD mortality after multivariate adjustment (RRs, 3.22 and 4.90, respectively).ConclusionsDepression and diabetes are associated with a significantly increased risk of all-cause and CVD mortality rate. The coexistence of these conditions identifies women at particularly high risk.

Dataset Information

Increased mortality for colorectal cancer patients with preexisting diabetes mellitus: an updated meta-analysis.

Background

Materials and methods

Results

Conclusions

Publications

Increased mortality for colorectal cancer patients with preexisting diabetes mellitus: an updated meta-analysis.

Similar Datasets

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