PDF(Pubmed)
Abstract：
UNASSIGNED: Early-onset colorectal cancer (CRC) is increasing in many developed countries. Type 2 diabetes mellitus has increased substantially in younger adults; however, its role in early-onset CRC remains unidentified.
UNASSIGNED: We conducted a claims-based nested case-control study using IBM MarketScan Commercial Database (2006-2015). Incident early-onset CRC diagnosed at ages 18-49 was identified by the International Classification of Diseases, ninth Revision, Clinical Modification diagnosis code, and the first coded diagnostic pathology date was assigned as the index date. Controls were frequency matched with cases. Type 2 diabetes, stratified by severity, was identified through International Classification of Diseases, ninth Revision, Clinical Modification using the Klabunde algorithm. Multivariable logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
UNASSIGNED: A total of 6001 early-onset CRC and 52,104 controls were included. Type 2 diabetes was associated with an increased risk of early-onset CRC (5.0% in cases vs 3.7% in controls; OR = 1.24, 95% CI: 1.09-1.41). The positive association was more pronounced for uncontrolled (OR = 1.37; 95% CI: 1.12-1.67) or complicated (OR = 1.59, 95% CI: 1.08-2.35) type 2 diabetes compared with controlled diabetes (OR = 1.13, 95% CI: 0.94-1.36).
UNASSIGNED: Individuals with type 2 diabetes have a higher risk of early-onset CRC, with stronger associations for uncontrolled diabetes and complicated diabetes. The rising prevalence of type 2 diabetes among younger adults may partially contribute to the increasing incidence of early-onset CRC.
UNASSIGNED: We conducted a claims-based nested case-control study using IBM MarketScan Commercial Database (2006-2015). Incident early-onset CRC diagnosed at ages 18-49 was identified by the International Classification of Diseases, ninth Revision, Clinical Modification diagnosis code, and the first coded diagnostic pathology date was assigned as the index date. Controls were frequency matched with cases. Type 2 diabetes, stratified by severity, was identified through International Classification of Diseases, ninth Revision, Clinical Modification using the Klabunde algorithm. Multivariable logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
UNASSIGNED: A total of 6001 early-onset CRC and 52,104 controls were included. Type 2 diabetes was associated with an increased risk of early-onset CRC (5.0% in cases vs 3.7% in controls; OR = 1.24, 95% CI: 1.09-1.41). The positive association was more pronounced for uncontrolled (OR = 1.37; 95% CI: 1.12-1.67) or complicated (OR = 1.59, 95% CI: 1.08-2.35) type 2 diabetes compared with controlled diabetes (OR = 1.13, 95% CI: 0.94-1.36).
UNASSIGNED: Individuals with type 2 diabetes have a higher risk of early-onset CRC, with stronger associations for uncontrolled diabetes and complicated diabetes. The rising prevalence of type 2 diabetes among younger adults may partially contribute to the increasing incidence of early-onset CRC.
摘要：
■早发性结直肠癌（CRC）在许多发达国家正在增加。2型糖尿病在年轻人中大幅增加；然而，其在早发性CRC中的作用尚不明确.
■我们使用IBMMarketScanCommercialDatabase（2006-2015）进行了基于索赔的嵌套案例对照研究。在18-49岁被诊断的早期发病CRC由国际疾病分类确定。第九次修订,临床修改诊断代码,并将第一个编码的诊断病理日期指定为索引日期。对照与病例频率匹配。2型糖尿病,按严重程度分层，是通过国际疾病分类确定的，第九次修订,使用Klabunde算法的临床修改。多变量逻辑回归用于估计比值比（OR）和95％置信区间（CI）。
■共纳入6001例早发性CRC和52,104例对照。2型糖尿病与早发性CRC的风险增加相关（病例为5.0％，对照组为3.7％；OR=1.24，95％CI：1.09-1.41）。与对照糖尿病（OR=1.13，95％CI：0.94-1.36）相比，未对照（OR=1.37；95％CI：1.12-1.67）或复杂（OR=1.59，95％CI：1.08-2.35）的2型糖尿病的正相关更为明显。
■2型糖尿病患者发生早发性CRC的风险更高，与不受控制的糖尿病和复杂的糖尿病有更强的关联。年轻人中2型糖尿病患病率的上升可能部分导致早发性CRC发病率的增加。
■我们使用IBMMarketScanCommercialDatabase（2006-2015）进行了基于索赔的嵌套案例对照研究。在18-49岁被诊断的早期发病CRC由国际疾病分类确定。第九次修订,临床修改诊断代码,并将第一个编码的诊断病理日期指定为索引日期。对照与病例频率匹配。2型糖尿病,按严重程度分层，是通过国际疾病分类确定的，第九次修订,使用Klabunde算法的临床修改。多变量逻辑回归用于估计比值比（OR）和95％置信区间（CI）。
■共纳入6001例早发性CRC和52,104例对照。2型糖尿病与早发性CRC的风险增加相关（病例为5.0％，对照组为3.7％；OR=1.24，95％CI：1.09-1.41）。与对照糖尿病（OR=1.13，95％CI：0.94-1.36）相比，未对照（OR=1.37；95％CI：1.12-1.67）或复杂（OR=1.59，95％CI：1.08-2.35）的2型糖尿病的正相关更为明显。
■2型糖尿病患者发生早发性CRC的风险更高，与不受控制的糖尿病和复杂的糖尿病有更强的关联。年轻人中2型糖尿病患病率的上升可能部分导致早发性CRC发病率的增加。
