Thomas Lawler, Elizabeth Hibler, Zoe L. Walts, Lauren Giurini, Mark Steinwandel, Loren Lipworth, Harvey J. Murff, Wei Zheng, Shaneda Warren Andersen
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Diabetes prior to diagnosis is associated with elevated overall (hazard ratio [95% confidence interval]: (1.46[1.22–1.75]), and CRC-specific mortality (1.36[1.06–1.74])) after adjustment for tumor stage. For non-Hispanic Black and non-Hispanic White participants, consistent associations were observed for overall (1.35[1.10–1.66] vs. 1.89[1.31–2.72], respectively, p-interaction = 0.11) and CRC-specific mortality (1.30[0.99–1.71] vs. 1.77[1.06–2.95], respectively, p-interaction = 0.28). For individuals with incomes <$15,000/year, associations with overall (1.44[1.15–1.79]) and CRC-specific mortality (1.28[0.94–1.73]) were similar to the full sample. Associations with overall (1.71[1.37–2.13]) and CRC-specific mortality (1.65[1.22–2.22]) were highest for diabetes ≥ 10 years at diagnosis. Pre-diagnosis diabetes is associated with higher mortality among participants with incident CRC from a predominantly non-Hispanic Black cohort with lower socioeconomic status. 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引用次数: 0
摘要
背景:我们调查了南方社区队列研究(Southern Community Cohort Study)中患有结直肠癌(CRC)的参与者中糖尿病与死亡率之间的关系:方法:参与者(73% 为非西班牙裔黑人;60% 为收入 结果:诊断前患糖尿病与总死亡率的升高有关(从 0.2% 升至 0.5%):经肿瘤分期调整后,诊断前糖尿病与总体死亡率(危险比[95% 置信区间]:1.46[1.22-1.75])和 CRC 特异性死亡率(1.36[1.06-1.74])升高有关。在非西班牙裔黑人和非西班牙裔白人参与者中,总体死亡率(分别为 1.35[1.10-1.66] vs. 1.89[1.31-2.72],p-交互作用 = 0.11)和 CRC 特异性死亡率(分别为 1.30[0.99-1.71] vs. 1.77[1.06-2.95],p-交互作用 = 0.28)的相关性一致。对于有收入的人 结论:诊断前糖尿病与癌症特异性死亡率相关:在社会经济地位较低的非西班牙裔黑人队列中,诊断前糖尿病与较高的 CRC 患者死亡率相关。该人群中较高的糖尿病患病率可能会导致 CRC 死亡率的种族差异。
Associations of diabetes and mortality among colorectal cancer patients from the Southern Community Cohort Study
We investigated associations between diabetes and mortality among participants with incident colorectal cancer (CRC) from the Southern Community Cohort Study. Participants (73% non-Hispanic Black; 60% income < $15,000) were recruited between 2002–2009. Diabetes was self-reported at enrollment and follow-up surveys at approximately 5-year intervals. Incident CRC and mortality were identified via state registries and the National Death Index. Proportional hazards models calculated associations between diabetes with overall, CRC-specific mortality among 1059 participants with incident CRC. Diabetes prior to diagnosis is associated with elevated overall (hazard ratio [95% confidence interval]: (1.46[1.22–1.75]), and CRC-specific mortality (1.36[1.06–1.74])) after adjustment for tumor stage. For non-Hispanic Black and non-Hispanic White participants, consistent associations were observed for overall (1.35[1.10–1.66] vs. 1.89[1.31–2.72], respectively, p-interaction = 0.11) and CRC-specific mortality (1.30[0.99–1.71] vs. 1.77[1.06–2.95], respectively, p-interaction = 0.28). For individuals with incomes <$15,000/year, associations with overall (1.44[1.15–1.79]) and CRC-specific mortality (1.28[0.94–1.73]) were similar to the full sample. Associations with overall (1.71[1.37–2.13]) and CRC-specific mortality (1.65[1.22–2.22]) were highest for diabetes ≥ 10 years at diagnosis. Pre-diagnosis diabetes is associated with higher mortality among participants with incident CRC from a predominantly non-Hispanic Black cohort with lower socioeconomic status. The higher prevalence of diabetes in this population may contribute to racial disparities in CRC mortality.
期刊介绍:
The British Journal of Cancer is one of the most-cited general cancer journals, publishing significant advances in translational and clinical cancer research.It also publishes high-quality reviews and thought-provoking comment on all aspects of cancer prevention,diagnosis and treatment.