Tony Tran presented a meta analysis, Is Diabetes Mellitus an Independent Risk Factor for Colon Cancer and Rectal Cancer? [PMID: 21912438], that reviewed studies that included diabetes as a potential factor associated with increased incidence of colorectal cancer.
The authors concluded that diabetes is an independent risk factor for colorectal cancer. In the paper, they authors wondered if colorectal cancer screening guidelines should be changed to included diabetes as either a risk factor, or if clinical practice should include longer prep times for patients with diabetes.
One question that arose in our discussion was how the increased risk of DM in this meta-analysis compared with the difference in incidence between African Americans and whites in colorectal cancer (a difference which lead the ACG to recommend initiating screening for African Americans at age 45 rather than age 50). The paper that was used as the basis of the ACG recommendation for earlier screening in African Americans is Colorectal cancer in African American, Agrawal S et al. Am J Gastroenterology. 100: 515-523. [PMID 15743345].
SCORE
Katie Garman presented the SCORE trial: Once-Only Sigmoidoscopy in Colorectal Cancer Screening: Follow-up Findings of the Italian Randomized Controlled Trial–SCORE. [PMID: 21852264], a randomized controlled trial performed in Italy that evaluated one-time flexible sigmoidscopy screening for colorectal cancer in Italy.
As with the recently published UK flex sig trial, both of these studies demonstrated benefit to colorectal cancer screening with flex sig. Dawn Provenzale created a table demonstrating the overall evidence in favor colorectal cancer screening. The key point is the importance of colorectal screening in improving incidence and survival.
