Purpose: Obesity and diabetes mellitus (DM) are risk factors for the development of colorectal cancer and are associated with the development of more proximal neoplasia. Obesity and type II DM are increasingly common in the US Hispanic population. The purpose of this study was to determine if obesity and DM are associated with more proximal colorectal cancers in an inner city Hispanic population.
Methods: Clinical data on 234 patients, from 1996 to 2006, diagnosed with CRC and with or without concurrent DM was retrieved from the institutional records. Patients’ data on age, gender, ethnicity, body mass index (BMI), stage and the location of the primary tumor was collected. Patients were defined as diabetic if they had a prior diagnosis or were diagnosed on admission. Patients without adenocarcinoma or who had incomplete data were excluded. Tumor location was compared between Hispanic CRC-DM and CRC patients without DM, and then analyzed by cross correlation while controlling for age, gender and stage of the tumor. The analysis was repeated testing for a relationship between location and BMI.
Results: A total of 72 Hispanic CRC (DM: 36, non-DM: 36) patients were enrolled; neither age, gender, nor stage were different between the two arms. The mean age was 56.2 +/- 14.9. The mean BMI was significantly higher in the diabetic group (29.7 +/- 8.0) versus the non-DM group (26.0 +/- 4.1, p<0.05). By cross correlation analysis, diabetics were more likely to have colon cancer than rectosigmoid or rectal cancer (p=0.001). This was again significant after controlling for age, gender, BMI and stage p<0.01. However, there was not a statistically significant correlation between BMI and location (p=0.055 and p=0.301 when controlling for the aforementioned factors).
Conclusions: This limited group of Hispanic individuals with CRC revealed that patients with type-II DM were more likely to have colon cancer than rectosigmoid or rectal cancer. This effect was not statistically likely to be a result of body mass index alone. Further study with a larger population base is warranted.