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Endocrine And Metabolic Diseases Among Colorectal Cancer Survivors In A Population-Based Cohort.

Makenzie L. Hawkins, Brenna E Blackburn, Kerry G Rowe, John Snyder, Vikrant G. Deshmukh, Michael Newman, Alison Fraser, Ken Robert Smith, Kimberly A. Herget, Patricia A. Ganz, Niloy Jewel Samadder, Mia Hashibe
Published 2019 · Medicine, Biology
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BACKGROUND There are an estimated 1.4 million colorectal cancer (CRC) survivors in the United States. Research on endocrine and metabolic diseases over the long term in CRC survivors is limited. Obesity is a risk factor for CRC, thus it is of interest to investigate diseases that may share this risk factor such as diabetes for long-term health outcomes among CRC survivors. METHODS A total of 7,114 CRC patients were identified from Utah Population Database and matched to a general population cohort of 25,979 individuals on birth year, sex, and birth state. Disease diagnoses (assessed over three-time periods of 1-5 years, 5-10 years, and >10 years) were identified using electronic medical records and statewide ambulatory and inpatient discharge data. Cox proportional hazard models were used to estimate the risk of endocrine and metabolic disease. RESULTS Across all three-time periods, risks for endocrine and metabolic diseases was statistically significantly greater for CRC survivors compared to the general population cohort. At 1-5 years post diagnosis, CRC survivors' risk for diabetes mellitus with complications was statistically significantly elevated (HR = 1.36, 99% CI = 1.09-1.70). CRC survivors also experienced a 40% increased risk of obesity at 1-5 years post cancer diagnosis (HR = 1.40, 99%CI= 1.66-2.18) and a 50% increased risk at 5-10 years post diagnosis (HR = 1.50, 99%CI= 1.16-1.95). CONCLUSIONS Endocrine and metabolic diseases were statistically significantly higher in CRC survivors throughout the follow up periods of 1-5 years, 5-10 years and greater than 10 years post diagnosis. As the number of CRC survivors increases, understanding the long-term trajectory is critical for improved survivorship care.
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