Diminishing differences in treatment between patients with colorectal cancer with and without diabetes

A population-based study

M.M.J. Zanders, L.N. van Steenbergen, H.R. Haak, H.J.T. Rutten, J.F.M. Pruijt, P.M.P. Poortmans, V.E.P.P. Lemmens, L.V. van de Poll-Franse

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Aims
An increasing number of oncologists will be confronted with individuals having diabetes and cancer. We assessed changes in patient-, tumour- and treatment-related variables in patients with colorectal cancer with and without diabetes.
Methods
All 17 170 cases of primary colorectal cancer between 1995 and 2010 in the South-Eastern Netherlands were included. The Cochrane–Armitage test and logistic regression analysis were used to analyse trends.
Results
In total, 11 893 patients were diagnosed with colon cancer and 5277 with rectal cancer, of whom 1711 (14%) and 609 (12%), respectively, had diabetes at the time of cancer diagnosis. Patients with colorectal cancer with diabetes compared with those without were approximately 5 years older and more often diagnosed with proximal colon tumours (60 vs. 54%; P < 0.0001). Chemotherapy administration significantly increased in patients with stage III colon cancer with and without diabetes (from 17% in 1995–1998 to 50% in 2007–2010, 38% to 63%, respectively; P < 0.0001). However, in the most recent period, and after adjusting for the co-variables age, gender, year of diagnosis and specific co-morbidities, patients with stage III colon cancer with diabetes received adjuvant chemotherapy less frequently than those without [odds ratio 0.7 (95% CI 0.5–0.9); P = 0.002]. The proportion of patients with stage II/III rectal cancer with and without diabetes who underwent radiotherapy has been similar in recent years (91 vs. 87%).
Conclusions
Although the administration of chemotherapy and radiotherapy increased between 1995 and 2010 in patients with colorectal cancer with and without diabetes, patients with colorectal cancer with diabetes continue to receive chemotherapy less frequently than those without diabetes.
Original languageEnglish
Pages (from-to)1181-1188
JournalDiabetic Medicine: Journal of Diabetes UK
Volume30
Issue number10
DOIs
Publication statusPublished - 2013

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Neoplasms
Adjuvant Chemotherapy
Netherlands
Logistic Models
Odds Ratio
Oncologists

Cite this

Zanders, M.M.J. ; van Steenbergen, L.N. ; Haak, H.R. ; Rutten, H.J.T. ; Pruijt, J.F.M. ; Poortmans, P.M.P. ; Lemmens, V.E.P.P. ; van de Poll-Franse, L.V. / Diminishing differences in treatment between patients with colorectal cancer with and without diabetes : A population-based study. In: Diabetic Medicine: Journal of Diabetes UK. 2013 ; Vol. 30, No. 10. pp. 1181-1188.
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title = "Diminishing differences in treatment between patients with colorectal cancer with and without diabetes: A population-based study",
abstract = "AimsAn increasing number of oncologists will be confronted with individuals having diabetes and cancer. We assessed changes in patient-, tumour- and treatment-related variables in patients with colorectal cancer with and without diabetes.MethodsAll 17 170 cases of primary colorectal cancer between 1995 and 2010 in the South-Eastern Netherlands were included. The Cochrane–Armitage test and logistic regression analysis were used to analyse trends.ResultsIn total, 11 893 patients were diagnosed with colon cancer and 5277 with rectal cancer, of whom 1711 (14{\%}) and 609 (12{\%}), respectively, had diabetes at the time of cancer diagnosis. Patients with colorectal cancer with diabetes compared with those without were approximately 5 years older and more often diagnosed with proximal colon tumours (60 vs. 54{\%}; P < 0.0001). Chemotherapy administration significantly increased in patients with stage III colon cancer with and without diabetes (from 17{\%} in 1995–1998 to 50{\%} in 2007–2010, 38{\%} to 63{\%}, respectively; P < 0.0001). However, in the most recent period, and after adjusting for the co-variables age, gender, year of diagnosis and specific co-morbidities, patients with stage III colon cancer with diabetes received adjuvant chemotherapy less frequently than those without [odds ratio 0.7 (95{\%} CI 0.5–0.9); P = 0.002]. The proportion of patients with stage II/III rectal cancer with and without diabetes who underwent radiotherapy has been similar in recent years (91 vs. 87{\%}).ConclusionsAlthough the administration of chemotherapy and radiotherapy increased between 1995 and 2010 in patients with colorectal cancer with and without diabetes, patients with colorectal cancer with diabetes continue to receive chemotherapy less frequently than those without diabetes.",
author = "M.M.J. Zanders and {van Steenbergen}, L.N. and H.R. Haak and H.J.T. Rutten and J.F.M. Pruijt and P.M.P. Poortmans and V.E.P.P. Lemmens and {van de Poll-Franse}, L.V.",
year = "2013",
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Diminishing differences in treatment between patients with colorectal cancer with and without diabetes : A population-based study. / Zanders, M.M.J.; van Steenbergen, L.N.; Haak, H.R.; Rutten, H.J.T.; Pruijt, J.F.M.; Poortmans, P.M.P.; Lemmens, V.E.P.P.; van de Poll-Franse, L.V.

In: Diabetic Medicine: Journal of Diabetes UK, Vol. 30, No. 10, 2013, p. 1181-1188.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Diminishing differences in treatment between patients with colorectal cancer with and without diabetes

T2 - A population-based study

AU - Zanders, M.M.J.

AU - van Steenbergen, L.N.

AU - Haak, H.R.

AU - Rutten, H.J.T.

AU - Pruijt, J.F.M.

AU - Poortmans, P.M.P.

AU - Lemmens, V.E.P.P.

AU - van de Poll-Franse, L.V.

PY - 2013

Y1 - 2013

N2 - AimsAn increasing number of oncologists will be confronted with individuals having diabetes and cancer. We assessed changes in patient-, tumour- and treatment-related variables in patients with colorectal cancer with and without diabetes.MethodsAll 17 170 cases of primary colorectal cancer between 1995 and 2010 in the South-Eastern Netherlands were included. The Cochrane–Armitage test and logistic regression analysis were used to analyse trends.ResultsIn total, 11 893 patients were diagnosed with colon cancer and 5277 with rectal cancer, of whom 1711 (14%) and 609 (12%), respectively, had diabetes at the time of cancer diagnosis. Patients with colorectal cancer with diabetes compared with those without were approximately 5 years older and more often diagnosed with proximal colon tumours (60 vs. 54%; P < 0.0001). Chemotherapy administration significantly increased in patients with stage III colon cancer with and without diabetes (from 17% in 1995–1998 to 50% in 2007–2010, 38% to 63%, respectively; P < 0.0001). However, in the most recent period, and after adjusting for the co-variables age, gender, year of diagnosis and specific co-morbidities, patients with stage III colon cancer with diabetes received adjuvant chemotherapy less frequently than those without [odds ratio 0.7 (95% CI 0.5–0.9); P = 0.002]. The proportion of patients with stage II/III rectal cancer with and without diabetes who underwent radiotherapy has been similar in recent years (91 vs. 87%).ConclusionsAlthough the administration of chemotherapy and radiotherapy increased between 1995 and 2010 in patients with colorectal cancer with and without diabetes, patients with colorectal cancer with diabetes continue to receive chemotherapy less frequently than those without diabetes.

AB - AimsAn increasing number of oncologists will be confronted with individuals having diabetes and cancer. We assessed changes in patient-, tumour- and treatment-related variables in patients with colorectal cancer with and without diabetes.MethodsAll 17 170 cases of primary colorectal cancer between 1995 and 2010 in the South-Eastern Netherlands were included. The Cochrane–Armitage test and logistic regression analysis were used to analyse trends.ResultsIn total, 11 893 patients were diagnosed with colon cancer and 5277 with rectal cancer, of whom 1711 (14%) and 609 (12%), respectively, had diabetes at the time of cancer diagnosis. Patients with colorectal cancer with diabetes compared with those without were approximately 5 years older and more often diagnosed with proximal colon tumours (60 vs. 54%; P < 0.0001). Chemotherapy administration significantly increased in patients with stage III colon cancer with and without diabetes (from 17% in 1995–1998 to 50% in 2007–2010, 38% to 63%, respectively; P < 0.0001). However, in the most recent period, and after adjusting for the co-variables age, gender, year of diagnosis and specific co-morbidities, patients with stage III colon cancer with diabetes received adjuvant chemotherapy less frequently than those without [odds ratio 0.7 (95% CI 0.5–0.9); P = 0.002]. The proportion of patients with stage II/III rectal cancer with and without diabetes who underwent radiotherapy has been similar in recent years (91 vs. 87%).ConclusionsAlthough the administration of chemotherapy and radiotherapy increased between 1995 and 2010 in patients with colorectal cancer with and without diabetes, patients with colorectal cancer with diabetes continue to receive chemotherapy less frequently than those without diabetes.

U2 - 10.1111/dme.12253

DO - 10.1111/dme.12253

M3 - Article

VL - 30

SP - 1181

EP - 1188

JO - Diabetic Medicine: Journal of the British Diabetic Association

JF - Diabetic Medicine: Journal of the British Diabetic Association

SN - 0742-3071

IS - 10

ER -