Colorectal carcinoma and diabetes mellitus

Authors: V. Procházka ;  R. Chlup
Authors‘ workplace: II. interní klinika Lékařské fakulty UP a FN Olomouc, přednosta doc. MUDr. Vlastimil Procházka, Ph. D.
Published in: Vnitř Lék 2008; 54(10): 979-984
Category: Reviews


The aim of this overview notification is to point out the risk factors and causes of colorectal carcinoma in diabetics. On the basis of recent information in the literature Type 2 diabetes mellitus has begun to appear as a potential risk factor for colorectal carcinoma. The work focuses on the link between them and outlines a possible solution to this topical issue. When tracking the diabetic population it is recommended that current depistage programmes for colorectal carcinoma be strictly maintained, that dispensing programmes not be neglected, in working with gastroenterologists to share the planning and specific preparation of a diabetic for endoscopy and other interventions and when treating with insulin to give preference to small complementary doses. It is proposed that the dispen-sing programme for this malignancy be modified for diabetics.

Key words:
diabetes mellitus – colorectal carcinoma – dispensing – depistage – epidemiology


1. Bowker SL, Majumdar SR, Veugelers P et al. Increased cancer‑related mortality for patients with type 2 diabetes who use sulfonyllureas or insulin. Diabetes Care 2006; 29: 254–258.

2. Cottet V, Pariente A, Nalet B et al. Colonoscopic screening of first-degree relatives of patients with large adenomas: increased risk of colorectal tumors. Gastroenterology 2007; 133: 1086–1092.

3. Ehrmann J Jr, Vavrušková N, Collan Y et al. Peorxisome proliferator‑activated receptors (PPARs) in health and disease. Biomed Pap Med Fac Univ Palacky Olomouc 2002; 146: 11–14.

4. Flood A, Mai V, Pfeiffer R et al. Elevated serum concentrations of insulin glucose increase risk of recurrent colorectal adenomas. Gastroenterology 2007; 133: 1423–1429.

5. Frič P, Zavoral M, Seifert B et al. Screening sporadického kolorektálního karcinomu v ČR. Interní Med 2007; 5: 221–224.

6. Huxley R, Ansary-Moghaddam A, Berrington GA et al. Type II diabetes and pancreatic cancer: a meta‑analysis of 36 studies. Br J Cancer 2005; 92: 2076–2083.

7. Chari ST, Leibon CL, Rabe KG et al. Pancreatic cancer‑associated diabetes mellitus: prevalence and temporal association with diagnosis of cancer. Gastroenterology 2008; 134: 344–345.

8. Chung YW, Han DS, Park KH et al. Insulin therapy and colorectal adenoma risk among patients with type 2 diabetes mellitus: A case-control study in Korea. Dis Colon Rectum 2008; 25, v tisku.

9. Chung YW, Han DS, Park YK et al. Association of obesity, serum glucose and lipids with the risk of advanced colorectal adenoma and cancer: a case-control study in Korea. Dig Liver Dis 2006; 38: 668–672.

10. Jenab M, Riboli E, Cleveland RJ et al. Serum C-peptid, IGFBP-1 and IGFBP-2 and risk of colon and rectal cancers in the European Prospective Investigation into Cancer and Nutrition. Int J Cancer 2007; 121: 368–376.

11. Kaaks R, Toniolo P, Akhmedkhanov A et al. Serum C-peptide, insulin‑like growth factor (IGF)-I, IGF‑binding proteins, and colorectal cancer risk in women. J Natl Cancer Inst 2000; 92: 1592–1600.

12. Keku TO, Lund PK, Galanko J et al. Insulin resistence, apoptosis, and colorectal adenoma. Cancer Epidemiol Biomarkers Rev 2005; 14: 2076–2081.

13. Larson SC, Orsini N, Wolk A. Diabetes mellitus and risk of colorectal cancer: J Natl Cancer Inst 2005; 97: 1679–1687.

14. Ma J, Giovannucci E, Pollak M et al. A prospective study of plasma C-peptide and colorectal cancer risk in men. J Natl Cancer Inst 2004; 96: 546–553.

15. Nagel JM, Göke B. Colorectal carcinoma screening in patients with type 2 diabetes mellitus. J Gastroenterol 2006; 44: 1153–1165.

16. Otani T, Iwasaki M, Sasazuki S et al. Plasma C-peptide, insulin‑like growth factor-I, insulin‑like growth factor bind-ing proteins and risk of colorectal cancer in a nested case-control study: the Japan public health center‑based prospective study. Int J Cancer 2007; 120: 2007–2012.

17. Saydah SH, Platz EA, Rifai N et al. Association of markers of insulin and glucose control with subsequent colorectal cancer risk. Cancer Epidemiol Biomarkers Prev 2003; 12: 412–418.

18. Schiel R, Müller UA, Braun A et al. Risk of malignancies in patients with insulin‑tread diabetes mellitus: results of a population‑based trial with 10-year follow‑up (JEVIN). Eur J Med Res 2005; 10: 339–344.

19. Stevens RJ, Roddam AW, Beral V. Pancreatic cancer in type 1 and young-onset diabetes: systematic review and meta‑analysis. Br J Cancer 2007; 96: 507–509.

20. Svačina Š, Matoušek M. Diabetes a kolorektální karcinom. In: Perušičová J. Trendy soudobé diabetologie, svazek 7, 1. vyd. Praha: Galén 2003: 123–141.

21. Svačina Š, Matoulek M, Svobodová Š et al. Nádory trávicího traktu a diabetes mellitus. Vnitř Lék 2004; 50: 386–391.

22. Urban O. Zvláštnosti diagnostiky onemocnění trávicího ústrojí u diabetiků. Praktický lékař 2003; 83: 630–634.

23. Ústav zdravotnických informací a statistiky ČR. Péče o nemocné cukrovkou 2006. In: Zdravotnická statistika. http:/

24. Will JC, Galuska DA, Vinicor F et al. Colorectal cancer: another complication of diabetes mellitus? Amer J Epidemiol 1998; 147: 816–825.

25. Winawer SJ, Zaber AG, Gerdes H et al. Risk of colorectal cancer in the families of patients with adenomatous polyps. National Polyp Study Workgroup. N Engl J Med 1996; 334: 1339–1340.

26. Yang YX, Hennessy S, Lewis JD. Insulin therapy and colorectal cancer risk among type 2 diabetes mellitus patients. Gastroenterology 2004; 127: 1044–1050.

27. Zavoral M, Frič P. Screening kolorektálního karcinomu. Interní Med 2007; 3: 149–150.

Diabetology Endocrinology Internal medicine
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account