Premium
Young‐onset colorectal cancer is associated with a personal history of type 2 diabetes
Author(s) -
Mikaeel Reger R.,
Symonds Erin L.,
Kimber James,
Smith Eric,
Horsnell Mehgan,
Uylaki Wendy,
Tapia Rico Gonzalo,
Hewett Peter J.,
Yong Jonathan,
Tonkin Darren,
Jesudason David,
Poplawski Nicola K.,
Ruszkiewicz Andrew R.,
Drew Paul A.,
Hardingham Jenny E.,
Wong Stephanie,
Frank Oliver,
Tomita Yoko,
Patel Dainik,
Vatandoust Sina,
Townsend Amanda R.,
Roder David,
Young Graeme P.,
Parry Susan,
Tomlinson Ian P.,
Wittert Gary,
Wattchow David,
Worthley Daniel L.,
Brooks William J.,
Price Timothy J.,
Young Joanne P.
Publication year - 2021
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.13428
Subject(s) - family history , medicine , colorectal cancer , odds ratio , type 2 diabetes , cancer , diabetes mellitus , confidence interval , medical history , incidence (geometry) , young adult , oncology , endocrinology , physics , optics
Background Colorectal cancer (CRC) is rising in incidence in young adults, and this observation is currently unexplained. We investigated whether having a personal history of type 2 diabetes mellitus (T2D) was a potential risk factor for young‐onset colorectal cancer (YOCRC). Methods The South Australian Young Onset (SAYO) CRC study is a series of young adults with CRC below age 55. Ninety unrelated YOCRC cases were recruited to the study. Personal history and detailed family history of T2D were obtained at face‐to‐face interview and confirmed from medical records. Whole exome sequencing was conducted on germline DNA from each CRC case. Controls for personal history studies of T2D were 240 patients with proven clear colonoscopies and no known CRC predispositions. Results The median age of YOCRC cases was 44 years (18–54) and of controls was 45 years (18–54), and 53% of both cases and controls were females ( P = 0.99). Left‐sided (distal) CRC was seen in 67/89 (75%) of cases. A personal history of T2D was confirmed in 17/90 (19%) YOCRC patients compared with controls (12/240, 5%; P < 0.001; odds ratio = 4.4; 95% confidence interval, 2.0–9.7). YOCRC patients frequently reported at least one first‐degree relative with T2D (32/85, 38%). Ten of 87 (12%) of YOCRC cases had CRC‐related pathogenic germline variants, however, no pathogenic variants in familial diabetes‐associated genes were seen. Conclusions Though the mechanism remains unclear, our observations suggest that there is enrichment for personal history of T2D in YOCRC patients. Impact A diagnosis of T2D could therefore potentially identify a subset of young adults at increased risk for CRC and in whom early screening might be appropriate.