Study shows diabetes and high blood pressure increase the risk of cancer recurrence and death
Results from a retrospective analysis of more than 36,000 individuals with colon cancer indicated that patients with early-stage disease plus diabetes or high blood pressure (2 components of metabolic syndrome) have an increased risk of death or cancer recurrence compared with those colon cancer patients without either condition.
“Our results suggest that patients with early-stage colon cancer who also have diabetes or hypertension may need to be followed more closely for recurrence and could potentially benefit from broader use of adjuvant chemotherapy,” said senior author Nestor Esnaola, MD, MPH, MBA, Chief of the Division of Surgical Oncology, Professor of Surgery, and Vice-Chair of Clinical and Academic Affairs in the Department of Surgery at Temple University School of Medicine.
As a group, diabetes, high blood pressure, obesity, low levels of good cholesterol, and high amounts of lipids in the blood are called metabolic syndrome, which affects 1 in 5 American adults.
In their quest to better understand the effects of metabolic syndrome on colon cancer, Esnaola and his team from Temple University School of Medicine and Fox Chase Cancer Center linked data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program to Medicare data from 1998 to 2006 on 36,079 patients with colon cancer. The data identified 7024 patients (19.5%) as having metabolic syndrome. Researchers examined the effect of metabolic syndrome components on colon cancer recurrence and overall survival, controlling for various sociodemographic factors, tumor factors, other medical conditions, and cancer treatment received.
“Metabolic syndrome as a whole had no apparent effect on colon cancer recurrence or survival,” said Esnaola. “When we teased out and analyzed the effect of each of its components, however, the data told a different story.”
Study results showed a significantly greater risk of cancer recurrence and death after treatment among patients with early-stage disease and diabetes or high blood pressure.
For instance, 5 years after diagnosis, 47.7% of patients without diabetes were still alive, compared with only 41.3% of patients with diabetes. Furthermore, cancer recurrence rates were approximately 8% higher in patients with diabetes or hypertension 5 years after diagnosis.
Researchers also discovered that patients with abnormally high levels of lipids in the blood had a decreased risk of disease recurrence and death from colon cancer. After 5 years, 52.7% of patients with abnormally high lipid levels were still alive, compared with 39% of patients with normal levels.
“Our results underscore the need for clinical trials to define the true benefits of metformin and statins in patients with early-stage colon cancer,” he said.
Study findings were published online in the journal Cancer.
Source: Temple Health.