Does Diabetes Affect Colorectal Cancer Survival?

Complications of diabetes can have numerous negative health effects, from impaired vision and nerve damage to kidney dysfunction and heart disease. In an analysis of information on adults with colorectal cancer, patients who also had diabetes—particularly those with diabetic complications—faced a higher risk of dying early. The results are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.

For the study, Kuo‐Liong Chien, MD, PhD, of National Taiwan University, and his colleagues examined data registered between 2007 and 2015 in the Taiwan Cancer Registry Database, which is linked to health insurance and death records. Their analysis included 59,202 individuals with stage I–III colorectal cancer who underwent potentially curative surgery to remove their tumors. Among these patients, 9,448 experienced a cancer recurrence and 21,031 died from any cause during the study period.

Compared with individuals without diabetes, those with uncomplicated diabetes were at a minimally or insignificantly higher risk of all‐cause and cancer‐specific death, whereas those with complicated diabetes had 85% higher odds of death from any cause and 41% higher odds of death from cancer. These associations were more pronounced in women and in patients with early‐stage colorectal cancer.

Also, compared to patients without diabetes, patients with uncomplicated or complicated diabetes had a 10–11% higher risk of colorectal cancer recurrence.

The mechanisms behind the relationship between diabetic severity and poor colorectal cancer prognosis could involve various pathways and responses triggered by high insulin and glucose levels in the blood, as well as elevated inflammatory states, which are characteristic of type 2 diabetes.

“While a higher diabetes prevalence was noted in patients with colorectal cancer, the study suggests that coordinated medical care involving multiple specialists can help prevent diabetes complications, potentially improving long-term colorectal cancer oncological outcomes, particularly in women and patients with early-stage cancer,” said Dr. Chien.

Reference: Hsu HY, Chern YJ, Hsu MS, et al. Diabetic severity and oncological outcomes of colorectal cancer following curative resection: A population-based cohort study in Taiwan diabetes and colorectal cancer prognosis. Cancer. 2023;n/a(n/a). doi: 10.1002/cncr.34975

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