TY - JOUR T1 - Diabetes, plasma glucose and incidence of colorectal cancer in Chinese adults: a prospective study of 0.5 million people JF - Journal of Epidemiology and Community Health JO - J Epidemiol Community Health SP - 919 LP - 925 DO - 10.1136/jech-2018-210651 VL - 72 IS - 10 AU - Yuanjie Pang AU - Christiana Kartsonaki AU - Yu Guo AU - Yiping Chen AU - Ling Yang AU - Zheng Bian AU - Fiona Bragg AU - Iona Y Millwood AU - Leijia Shen AU - Songgen Zhou AU - Jiben Liu AU - Junshi Chen AU - Liming Li AU - Michael V Holmes AU - Zhengming Chen Y1 - 2018/10/01 UR - http://jech.bmj.com/content/72/10/919.abstract N2 - Background Diabetes is associated with higher risk of colorectal cancer (CRC). Uncertainty remains about the relevance of duration of diabetes and about the association of blood glucose with CRC risk among individuals without diabetes.Methods The prospective China Kadoorie Biobank recruited 512 713 participants in 2004–2008 from 10 diverse areas in China. After 10 years of follow-up, 3024 incident cases of CRC (1745 colon, 1716 rectal) were recorded among 510 136 participants without prior cancer at baseline. Cox regression was used to estimate adjusted HRs for CRC associated with diabetes (previously diagnosed or screen-detected) and, among those without previously diagnosed diabetes, with levels of random plasma glucose (RPG).Results Overall 5.8% of participants had diabetes at baseline. Individuals with diabetes had an adjusted HR of 1.18 (95% CI 1.04 to 1.33) for CRC, with similar risk for colon and rectal cancer (1.19 [1.01 to 1.39] vs 1.14 [0.96 to 1.35]). The HRs decreased with longer duration of diabetes (p for trend 0.03). Among those without previously diagnosed diabetes, RPG was positively associated with CRC, with adjusted HRs per 1 mmol/L higher baseline RPG of 1.04 (1.02 to 1.05) for CRC, again similar for colon and rectal cancer (1.03 [1.01to 1.05] and 1.04 [1.02 to 1.06], respectively). The associations of diabetes and RPG appeared stronger in men than in women, but the differences were non-significant (p for heterogeneity 0.3 and 0.2).Discussion Among Chinese adults, diabetes and higher blood glucose levels among those without known diabetes are associated with higher risk of CRC. ER -