LOS ANGELES — The risk of developing colorectal adenomas is increased both in women with diabetes and in individuals with coronary artery disease, according to two studies presented at the annual Digestive Disease Week.
Postmenopausal women with type 2 diabetes mellitus who are not taking hormone therapy are at increased risk for colorectal adenomas and advanced adenomas, compared with women without the disease, said Dr. Jill E. Elwing of Washington University in St. Louis. She and her colleagues selected 100 women with type 2 diabetes and 500 nondiabetic women to undergo screening colonoscopy at an outpatient endoscopy center.
A total of 37% of diabetic women had any type of adenoma, compared with 24% of nondiabetics, and 14% of diabetic women had an advanced adenoma, compared with 6% of nondiabetic women. These differences between groups were statistically significant.
Obesity compounded the risk for diabetic women, Dr. Elwing reported. A total of 42% of obese diabetic women had any adenoma, compared with 23% of the nonobese, nondiabetic women. Similarly, 19% of obese diabetic women had an advanced adenoma vs. 7% in the comparison group. In addition, diabetic women were more likely than nondiabetic women to have multiple adenomas and proximally located advanced adenomas.
The association between diabetes in women and colorectal adenomas and advanced adenomas was maintained even when researchers controlled for age, race, use of nonsteroidal anti-inflammatory drugs, and body mass index.
With confirmation of these findings, professional societies should consider incorporating diabetes as a risk factor in screening guidelines for colorectal disease, Dr. Elwing said.
A separate study looking at risk factors for developing colorectal cancer found that patients with coronary artery disease (CAD) are at greater risk for developing colorectal adenomas or colorectal cancer than are patients without CAD.
These findings suggest that patients with CAD should be screened using colonoscopy, recommended the study's lead author, Dr. Annie On On Chan of the University of Hong Kong.
The researchers recruited 307 patients who had a coronary angiogram, underwent screening colonoscopy, and completed a questionnaire on risk factors.
Interim results show that about 46% of the study subjects had CAD. The patients with CAD had a higher incidence of adenomas and cancer than did those without CAD (30% vs. 19%). Nearly 17% of the CAD population had advanced lesions, compared with less than 7% of the patients without CAD. The researchers found five cases of colorectal cancer among the CAD patients but none among those without CAD, Dr. Chan said.