Significantly higher rates of multiple and proximally located adenomas among patients with diabetes mellitus: A cross-sectional population-based study

Abstract

Background: Diabetes mellitus (DM) is associated with a greater risk for colorectal cancer (CRC). Objective: The objective of this article is to examine the endoscopic phenotype and histopathology of colorectal polyps in patients with vs without DM. Methods: We conducted a cross-sectional study of patients who underwent colonoscopy at our university hospital and who completed a questionnaire. We collected endoscopy and histopathology data regarding colorectal adenomas and serrated polyps. Cox regression analyses were used to estimate adjusted prevalence ratios (PRs). Results: We examined a total of 3654 patients (mean age (SD): 62 (12) years, 47% males). Of them, 360 (9.9%) had DM. Overall, the prevalence of colorectal adenomas (42% vs 32%, p < 0.01), multiple (≥3) adenomas (12% vs 7%, p = 0.01) and proximal adenomas (30% vs 19%, p < 0.01) was higher in patients with vs without DM. Multivariable analysis showed that the prevalence of adenomas (PR 1.17, 95% CI; 1.02–1.34), multiple (PR 1.37, 95% CI; 1.00–1.86) and proximal (PR 1.37, 95% CI; 1.16–1.62) adenomas was higher in patients with vs without DM, especially in men. Conclusion: Patients with DM harbor more frequently multiple and proximal adenomas than those without DM. Close colonoscopic surveillance of DM patients is important to maximize the effectiveness of colonoscopic CRC prevention.