Endocrine and metabolic diseases among colorectal cancer survivors in a population-based cohort.

Authors

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Makenzie Hawkins

Division of Public Health, Department of Family and Preventive Medicine, University of Utah, School of Medicine, Salt Lake City, UT

Makenzie Hawkins , Sean Patrick Soisson , Brenna Blackburn , Kerry G. Rowe , Vikrant Deshmukh , Michael Newman , Yuan Wan , Alison M Fraser , Ken R Smith , Cornelia M Ulrich , Patricia A. Ganz , Niloy Jewel Samadder , Mia Hashibe

Organizations

Division of Public Health, Department of Family and Preventive Medicine, University of Utah, School of Medicine, Salt Lake City, UT, Intermountain Healthcare, Salt Lake City, UT, University of Utah Health Sciences Center, Salt Lake City, UT, Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, University of Utah Huntsman Cancer Institute, Salt Lake City, UT, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, Department of Population Health Sciences and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, University of California, Los Angeles, Los Angeles, CA, Division of Gastroenterology, Department of Internal Medicine, and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT

Research Funding

Other

Background: Colorectal cancer is the third most common cancer among men and women in the United States. As of 2016, there were an estimated 1.4 million colorectal cancer survivors. Research on endocrine and metabolic diseases over the long term in colorectal cancer survivors is limited. Obesity is a risk factor for colorectal cancer, thus it is of interest to investigate diseases that may share this risk factor such as diabetes for long term health effects among survivors. Methods: A total of 7,077 colorectal cancer patients who were diagnosed between 1997 to 2012 were identified in the Utah Population Database. A general population cohort of 35,354 individuals was matched on birth year, sex, birth state and follow-up time as a comparison group. Late effects were identified using electronic medical records and statewide ambulatory and inpatient data and were assessed over three time periods of 1-5 years, 5-10 years, and > 10 years. Cox proportional hazard models were used to estimate the risk of late effects after adjusting for matching factors, race, baseline body mass index, and the baseline Charlson Comorbidity Index. Results: Across all three time periods, late effects risk for endocrine diseases and metabolic disorders was significantly greater for colorectal cancer survivors compared to the general population cohort. Risk for diabetes mellitus with complications was significantly increased for survivors and risk was greatest for uncontrolled diabetes (HR = 5.04, 99%CI = 2.38, 10.67) and diabetes with neurological manifestations (HR = 4.10, 99%CI = 2.08, 8.26). Higher risk was also observed for thyroid disorders (HR = 3.09, 99%CI = 2.34, 4.08) and nutritional deficiencies (HR = 4.98, 99%CI = 3.47, 7.17). The risk of obesity in survivors was greatest 1-5 years post cancer diagnosis (HR = 5.04, 99%CI = 2.91, 8.75), but remained significantly increased at all follow-up time periods. Conclusions: Endocrine and metabolic diseases were significantly higher in colorectal cancer survivors across the follow-up periods. As the number of colorectal cancer survivors increases, understanding the long term multimorbidity trajectory is critical for improved survivorship care.

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Patient and Survivor Care

Track

Patient and Survivor Care

Sub Track

Survivorship

Citation

J Clin Oncol 35, 2017 (suppl; abstr 10074)

DOI

10.1200/JCO.2017.35.15_suppl.10074

Abstract #

10074

Poster Bd #

63

Abstract Disclosures