Diabetes Linked to Death from Colorectal Cancer

Being diagnosed with Type 2 diabetes makes it more likely that men and women with colorectal cancer will die from colon or rectal cancer, from cardiovascular disease, or from any cause.

Diabetes increased risk of dying from colorectal cancer about 30 percent and more than doubled chances of dying from heart disease or stroke.  Overall deaths among early stage colon and rectal cancer patients was increased about 50 percent when they had diabetes before their colorectal cancer diagnosis.

For patients initially diagnosed with stage I, II, or III cancer, the chance of not dying from colorectal cancer within 5 years was 82 percent with Type 2 diabetes and 87 percent without it.

Five years after a colorectal cancer diagnosis about 3 out of 10 patients with diabetes died from any disease, compared to 2 out of 10 without diabetes.

Over 184,000 men and women in the Cancer Prevention Study-II Nutrition Cohort were tracked from their enrollment in the study in 1992-1993 through 2007.  During that time, 2,278 were diagnosed with colorectal cancer that had not spread to other organs (stages I, II, and III).

In that smaller group, 842 died, including 377 from colon or rectal cancer and 152 from heart disease or a stroke.

Epidemiologists at the American Cancer Society analyzed information from participant questionnaires answered at the beginning of the study and regularly throughout it to look for patterns of Type 2 diabetes and risk of dying.  They verified information through medical records, state cancer registries, and the National Death Index.

For men and women risk of dying from:

  • any cause was about 50% higher in those with Type 2 diabetes (relative risk 1.53).
  • colon or rectal cancer was 30% higher with Type 2 diabetes (relative risk 1.29).
  • cardiovascular disease was more than twice as high than those without Type 2 diabetes (relative risk 2.16).

Overall, colorectal cancer patients with diabetes were older, more obese, ate more red meat, and more often said they also had cardiovascular disease.

However, diabetes didn’t make the risk of death worse in men or women, colon or rectal cancer, or at different stages when they were diagnosed.

The length of time someone had known they had Type 2 diabetes or their use of insulin didn’t impact their overall risk of dying either.  Insulin use appeared to reduce risk of dying from colorectal cancer, but the number of patients using insulin was very small so this information may not be reliable.

Ahmed N. Dehal and his team at the American Cancer Society concluded,

Patients with colorectal cancer and Type 2 diabetes have a higher risk of mortality than patients with colorectal cancer who do not have Type 2 diabetes, especially a higher risk of death from cardiovascular disease.

SOURCE: Dehal et al, The Journal of Clinical Oncology, Published Ahead of Print, November 28, 2011.

What This Means for Patients

Many of the things that reduce the risk of getting diabetes also reduce the risk of colorectal cancer including:

  • Maintaining a normal weight and avoiding obesity.
  • Increasing physical activity.
  • Eating a variety of fruits and vegetables.

Cardiovascular deaths were actually more likely to occur in the Cancer Prevention Study-II Nutrition Cohort with colorectal cancer and diabetes.  Work with your doctor to reduce heart attack and stroke by

  • Not smoking.
  • Maintaining healthy weight  with heart-healthy diet and exercise.
  • Reducing salt.
  • Controlling high blood pressure.
  • Reducing high cholesterol.


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