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"Metabolic syndrome is a conglomeration of three or four diseases, that together can portend a worse prognosis for certain illnesses, including a number of cancers," said study co-author Dr. Donald Garrow, a clinical gastroenterology fellow at the Medical University of South Carolina in Charleston.
"But what has not been well-defined," he added, "is the associated risk for colorectal cancer. So this is one of the first -- and certainly the largest -- study to look specifically at this risk. And we found that there is indeed a higher risk for colorectal cancer in this population."
Garrow and his colleague, Dr. Mark Delegge, presented their findings last week at the American College of Gastroenterology scientific meeting, in Orlando, Fla.
The researchers noted that metabolic syndrome is a combination of three chronic conditions that are linked to being either overweight or obese: high blood pressure, diabetes and elevated cholesterol. The syndrome is already known to increase the risk for developing heart disease and stroke.
To gauge the degree to which having these conditions in concert might raise colon cancer risk as well, the authors reviewed data collected between 2000 and 2003 by the National Health Interview Survey. The nationwide survey is conducted annually by the National Center for Health Statistics.
The team focused on survey participants who had reported having a history of metabolic syndrome -- almost 1,200 patients -- and those with a history of colorectal cancer -- 350 patients.
After controlling for mitigating factors such as age, race, gender, obesity, and smoking and drinking habits, a cross-referencing of disease data revealed that patients with metabolic syndrome did, in fact, bear a significantly higher risk for colorectal cancer.
"This is concerning, because colon cancer is a disease that is preventable if patients get screened as recommended," said Garrow. "So, we hope with this study will encourage patients with metabolic syndrome to adhere to screening guidelines."
Dr. George Chang, an assistant professor of surgical oncology at M.D. Anderson Cancer Center at the University of Texas in Houston, agreed.
"I think this kind of a study emphasizes the importance of screening, and importance of adhering to the current guidelines," he said. "What the study does not do is evaluate if patients with metabolic syndrome develop colon cancer at an earlier age. So, there is insufficient evidence here to necessarily change our screening recommendations to encourage metabolic syndrome patients specifically to go in for earlier screening than they would otherwise if they followed current guidelines."
"However, I think this certainly is an area that warrants further investigation," added Chang, "to see if we can better identify those patients who are at higher risk for colorectal cancer."
In a second study also presented at the meeting, researchers revealed that initiating colon cancer screening 10 years prior to Medicare eligibility at 65 appears to save $2 in health-care costs for every $1 spent.
The finding stems from an analysis conducted by Scott Tenner and his colleagues from the State University of New York and New York College of Osteopathic Medicine, after they administered free colonoscopies to 248 Brooklyn residents who had an average age of 55. The initiative was launched as part of a colon cancer screening program.
The program -- which determined that 45 percent of the patients had polyps of varying sizes, while five patients had early-stage colon cancer -- cost $390,000 to run. The team concluded that had the same patients waited until the age of 65 to get screened, the cost of screening and treating those who needed care a decade later would have ballooned to $1.3 million.
SOURCES: Donald Garrow, M.D., MSCR, clinical gastroenterology fellow, Medical University of South Carolina, Charleston; George Chang, M.D., assistant professor, surgical oncology, University of Texas M.D. Anderson Cancer Center, Houston; Oct. 3-8, 2008, American College of Gastroenterology scientific meeting, Orlando, Fla.
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