Diabetes Mellitus raise the Risk for Interval Colorectal Cancer and Advanced Colorectal Adenomas

Interval colorectal cancer (ICRC) means CRC discovered at or before the second colonoscopy during a screening interval. Literature provides data concerning the present issue, 7.2-9% of CRCs meeting the definition of interval CRC, without knowing the risk factors for this. We aimed to study if diabetes mellitus (DM) patients have a greater risk to develop ICRC/advanced adenomas (ACRA). We randomly included in the study 50 patients aged over 50 years old diagnosed with DM in whom colonoscopy was done for different reasons. Were excluded patients with CRC/ACRA diagnosed at first colonoscopy and results were compared to those of an age/gender-matched group of patients without DM as background. The interval of colonoscopies was fixed at 36 months (the shortest interval used for surveillance after a polypectomy). The total number of interval lesions significantly differs in our two groups (p=0.022, q=0.17). Interval CRC, serrated adenomas and villous adenomas were more frequent in the T2D group. (p = 0.013, p= 0.032, respectively p=0.011, q=0.14). DALM lesions were more frequently present in controls than in T2D (p=0.049) Results showed that patients with interval ICRC were two times more in DM group in male gender (p=0.003, ss) (4 pts, respectively 2 pts) and 1.5 times greater in female group (3 pts, respectively 2 pts). The rate of CRC occurrence during the interval period of 36 months was 0.16% for male and 0.12% for females. Regarding the occurrence of ACRA (villous/tubulovillous adenomas), male patients with DM had 3 times more ACRA lesions than the control group (p=0.029, ss) (9 pts vs 3 pts) while females patients with DM had 2 times more ACRA than controls (p=0.031, ss) (6 pts vs 3 pts). The rate of interval advanced CR lesions occurrence during the interval period of 36 months was 0.36% for male and 0.24% for females. DM looks be a risk factor ICRC/ACRA by accelerating the colorectal epithelial proliferation rate. Male gender looks to be more exposed to ICRC/ACRC, especially when they are diagnosed with metabolic co-morbidities like T2D.