Obesity, diabetes boost death risk from colorectal cancer
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Maria Cendejas
Sunday Dec 31, 2011 (foodconsumer.org) -- People who have been diagnosed with colon cancer have a poorer prognosis if they overweight or have type 2 diabetes mellitus, according to two studies published in the Journal of Clinical Oncology.
The two studies looked at the impact that body-mass index and a diagnosis of type 2 diabetes had on survival rates after a colon cancer diagnosis found that both factors influence whether a patient survives colorectal cancer.
Also both studies found those people who were overweight or had type 2 diabetes type were more likely to die from any cause, including heart disease.
The first study led by Peter T. Campbell, PhD, of American Cancer Society and colleagues included 2,303 people who were in an unfinished study that began in 1992. Between 1992 and 2007, the study participants were diagnosed with colorectal cancer. Their follow-up continued through December 2008.
During the study, 851 people with colorectal cancer died, 380 died as a result of colorectal cancer, and 153 died of heart disease. The remaining 318 people died of other causes.
The risk of death was 30% higher for those who were overweight at the start of the study compared with those people of a normal weight. The risk of dying from heart disease was 68% higher, and the risk of dying from colorectal cancer was 35% higher.
Dr. Jeffrey Meyerhardt at the Dana-Farber Cancer Institute and Harvard Medical School in Boston explained in an editorial that the researchers tried to adjust the data for other important factors such red meat intake and physical activity. Even after modifying the data, obesity increased the death risk among people with colorectal cancer.
"In and of itself, obesity does seem to have some effect," Meyerhardt said.
For the second study, Campbell et al. recruited 2,278 people who had been diagnosed with non-metastatic colon or rectal cancer between 1992-2007. In the group, there were 842 deaths. 377 of those people died from colorectal cancer and 152 were from heart disease.
The study found people who had type 2 diabetes mellitus were 53% more likely to die from any cause and 29% more likely to die from colorectal cancer, compared to people who did not have type 2 diabetes. The risk of dying from heart disease was 2.16 times higher in people with type 2 diabetes and nearly four times higher in people with type 2 diabetes who used insulin, compared to the people that didn't have type 2 diabetes.
"Insulin use in type 2 diabetes usually indicates longer-standing diabetes, which is usually associated with worse outcomes." Meyerhardt noted.
"Obesity, elevated body-mass index and diabetes are associated with worse disease states across the board. But, we don't know if you lose weight if that risk will go down. I don't counsel patients who've been diagnosed with colorectal cancer to lose weight, because weight loss tends to be a worry in people undergoing cancer treatment anyway. I do counsel my patients that haven't been diagnosed with cancer to lose weight. The medical community needs to spend more time counseling prevention." said Dr. David Bernstein, chief of gastroenterology at North Shore University Hospital in Manhasset, New York.
Colorectal cancer, which is diagnosed in more than 101,000 people in the U.S. each year and kills about 50,000 annually in the country, is in many cases preventable. Eating large amounts of fiber-rich plant foods and reducing intake of meat are two things people can do to reduce their risk for colorectal cancer.
On the other hand, eating starchy foods would not increase the risk for the disease, according to a study Larsson S.C. and colleagues of Karolinska Institutet, Stockholm, Sweden published in the Feb 1, 2011 issue of American Journal of Epidemiology. This prospective study disproves the hypothesis that a high carbohydrate intake, a high glycemic index, and a high glycemic load increase the risk of colorectal cancer. H.L. Li and colleagues of Shanghai Cancer Institute in Shanghai China reported in the Jan 2011 issue of American Journal of Clinical Nutrition that they too did not find any evidence to support such a hypothesis.
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