Abstract
Colorectal cancer (CRC) is a significant global health concern, with studies projecting a rise in new cases to 2.5 million by 2035. Known risk factors include diet, lifestyle, and family history, while protective factors include physical activity and certain medications. Type 2 diabetes (T2D) is also a growing issue, with an estimated 642 million adults affected by 2040. However, the relationship between T2D, its medications, and CRC risk and pathological features remains unclear. This study in the Iranian population aimed to investigate this association. This case-control study involving 684 colorectal cancer cases and 811 controls found a significant positive association between type 2 diabetes and the risk of colorectal cancer (OR = 1.39). Sulfonylurea use was also associated with a higher risk of colorectal cancer among diabetic patients (OR = 2.35). The study also observed insignificant association between diabetes and pathological features of tumors. While limitations exist, these findings suggest the need for enhanced screening in diabetic patients, especially those on sulfonylureas. Further research is necessary to establish causality and understand the impact of individual medications on CRC risk. These results have implications for clinical practice and public health strategies in colorectal cancer prevention for diabetic patients.