Hubungan antara Diabetes Melitus terhadap Kejadian Kanker Kolorektal di RSUP H. Adam Malik Medan

Abstract

Introduction: Colorectal cancer is one of the leading cancers in terms of incidence and mortality worldwide, including in Indonesia. Type 2 diabetes mellitus (T2DM) is increasingly recognized as a significant risk factor for the development of colorectal cancer, with underlying mechanisms involving insulin resistance, hyperinsulinemia, impaired glucose metabolism, and chronic inflammation that promote malignant transformation. While international epidemiological studies have demonstrated an increased risk of colorectal cancer among patients with T2DM, local data in Indonesia, particularly in Medan, remain limited. Objective: This study aimed to analyze the association between type 2 diabetes mellitus and the incidence of colorectal cancer, as well as to assess the relationship between glycemic parameters (random blood glucose, fasting blood glucose, 2-hour postprandial glucose, and HbA1c) and the progression of colorectal cancer at RSUP H. Adam Malik Medan. Methods: This was an analytical observational study with a cross-sectional design, involving 61 colorectal cancer patients treated at the digestive surgery division of RSUP H. Adam Malik Medan from March to June 2025. Data were collected through consecutive sampling and included demographic characteristics (age, gender), history of T2DM, laboratory results for random blood glucose, fasting blood glucose, 2-hour postprandial glucose, HbA1c, and cancer stage. Statistical analysis used the chi-square test to evaluate the association between T2DM and glycemic parameters with the incidence and progression of colorectal cancer. Results: Most colorectal cancer patients were male, with the largest age group being 50–69 years. Of all patients, 37.7% had a history of type 2 diabetes mellitus. There was a statistically significant association between T2DM and the incidence of colorectal cancer (p=0.042). Furthermore, high glycemic parameters—random blood glucose ≥200 mg/dL, fasting blood glucose ≥126 mg/dL, 2-hour postprandial glucose ≥200 mg/dL, and HbA1c ≥6.5%—were significantly more common in patients with advanced-stage colorectal cancer compared to early-stage cases (p<0.05 for all parameters). The majority of patients had adenocarcinoma as the histopathological type. Conclusion: Type 2 diabetes mellitus is a significant risk factor for the incidence of colorectal cancer. Poor glycemic control is associated with the progression of colorectal cancer. Most colorectal cancer patients were male and aged 50–69 years, with adenocarcinoma as the most common histopathological type. These findings highlight the importance of optimal metabolic control in diabetic patients to reduce the risk and progression of colorectal cancer.