Diabetes mellitus and increased risk of biliary tract cancer: systematic review and meta-analysis

Ren, Hongbo; Yu, Tao; Liu, Chao; Li, Yanqing

doi:10.1007/s10552-011-9754-3

Cited by 79 publications

(62 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Particularly, findings on BTC were inconsistent after controlling for obesity [2]. Furthermore, most of the studies accounted for general obesity, but not for abdominal obesity, which we have previously shown to be an independent risk factor for GBC and HCC [9].…”

Section: Introductionmentioning

confidence: 85%

See 1 more Smart Citation

Diabetes mellitus, insulin treatment, diabetes duration, and risk of biliary tract cancer and hepatocellular carcinoma in a European cohort

et al. 2013

View full text Add to dashboard Cite

Background: Evidence on associations between self-reported diabetes mellitus, diabetes duration, age at diabetes diagnosis, insulin treatment, and risk of biliary tract cancer (BTC) and hepatocellular carcinoma (HCC), independent of general and abdominal obesity is scarce. Patients and methods: We conducted a prospective analysis in the EPIC-cohort study among 363 426 participants with self-reported diabetes data. Multivariable adjusted relative risks and 95% confidence intervals were estimated from Cox regression models. In a nested case-control subset, analyses were carried out in HCV/HBV-negative individuals.Results: During 8.5 years of follow-up, 204 BTC cases [including 75 gallbladder cancer (GBC) cases], and 176 HCC cases were identified. Independent of body mass index and waist-to-height ratio diabetes status was associated with higher risk of BTC and HCC [1.77 (1.00-3.13) and 2.17 (1.36-3.47)]. For BTC, the risk seemed to be higher in participants with shorter diabetes duration and those not treated with insulin. Regarding cancer subsites, diabetes was only associated with GBC [2.72 (1.17-6.31)]. The risk for HCC was particularly higher in participants treated with insulin. The results were not appreciably different in HCV/HBV-negative individuals. Conclusion(s):This study supports the hypothesis that diabetes is a risk factor for BTC ( particularly GBC) and HCC.Further research is required to establish whether diabetes treatment or duration is associated with these cancers.

show abstract

Section: Introductionmentioning

confidence: 85%

“…Studies on biliary tract cancer (BTC), including extrahepatic bile duct (EBD) and gallbladder cancer (GBC), have shown inconsistent results regarding diabetes status [2], whereas the evidence for an association between diabetes and hepatocellular carcinoma (HCC) has been more straightforward [3,4].…”

Section: Introductionmentioning

confidence: 99%

Diabetes mellitus, insulin treatment, diabetes duration, and risk of biliary tract cancer and hepatocellular carcinoma in a European cohort

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Previous meta-analyses have demonstrated that DM is associated with increased risks of breast, colon and pancreatic cancers (4,10,25,26). Furthermore, a recent German cohort study identified an excess overall cancer risk among diabetic patients, with an odds ratio for all cancers of 1.64 in comparison with the control group (27).…”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Gastrointestinal Malignancy in Patients with Diabetes Mellitus and Correlations with Anti-Diabetes Drugs: A Nationwide Population-based Study in Taiwan

et al. 2013

View full text Add to dashboard Cite

Objective Although the major cause of morbidity and mortality in patients with diabetes mellitus (DM) is cardiovascular disease, DM is also associated with certain site-specific cancers. However, whether DM is associated with an increased risk of cancer of the digestive tract remains undetermined. A nationwide, population-based database in Taiwan was analyzed to explore the relationship between DM and cancer of the digestive organs. Methods From 2000 to 2007, a study cohort consisting of 39,515 patients with newly diagnosed diabetes without a previous diagnosis of gastrointestinal (GI) cancer was identified from the National Health Insurance Research Database in Taiwan. A control cohort of 79,030 age-and sex-matched non-diabetic subjects was selected to compare the occurrence of GI malignancies between the two groups. The association between the incidence of GI cancers and the use of glucose-lowering therapies was also investigated. Results During the 7-year follow-up period, GI cancers developed in 929 diabetic patients (2.35%) and 1,126 subjects (1.42%) in the comparison cohort. DM was associated with a 2.75-fold (95% confidence interval (CI), 2.51-3.02) higher risk of developing GI malignancy. Among GI cancers, the incidences of stomach (adjusted hazard ratio (HR), 1.49; 95% CI, 1.16-1.92), liver (adjusted HR, 2.65; 95% CI, 2.29-3.07), colon (adjusted HR, 1.58; 95% CI, 1.28-1.94) and pancreatic cancers (adjusted HR, 4.35; 95% CI, 2.93-6.47) were significantly increased in the patients with DM. An analysis of the effects of various glucose-lowering therapies in the diabetic patients revealed the use of α-glucosidase inhibitors to be associated with a lower risk of hepatic cancer (adjusted HR, 0.62; 95% CI, 0.4-0.94). Thiazolidinedione (TZD) treatment was associated with lower stomach (adjusted HR, 0.11; 95% CI, 0.02-0.82) and hepatic cancer risks (adjusted HR, 0.46; 95% CI, 0.29-0.73), while sulfonylurea use was associated with a lower colon cancer risk (adjusted HR, 0.74; 95% CI, 0.51-1.09) and a higher pancreatic cancer risk (adjusted HR, 2.36; 95% CI, 1.21-4.61). Conclusion Patients with DM have an increased risk of GI malignancy that may be affected by the use of different categories of glucose-lowering therapies.

show abstract

“…Gallstone is closely in related to GBC risk [41]. Meanwhile, obesity tends to be accompanied with DM, which is also associated with increased GBC risk [6,42]. However, most studies did not adjust for these risk factors.…”

Section: Discussionmentioning

confidence: 99%

Body Mass Index and the Risk of Gallbladder Cancer: An Updated Meta-analysis of Epidemiologic Studies

Zeng¹

2014

J Gastrointest Dig Syst

View full text Add to dashboard Cite

Objectives: To provide a quantitative assessment of the association between excess bodyweight, expressed as increased body-mass index (BMI), and the risk of gallbladder cancer (GBC), we conducted an updated metaanalysis of epidemiologic studies. Methods:We searched the MEDLINE and EMBASE databases form1966 to February 2013, and the reference lists of retrieved articles. A random-effects model was used to combine study-specific results. A total of 12 cohort studies (involving 5,101 cases) and 8 case-control studies (1,013 cases and 43,591 controls) were included in the meta-analysis.Results: Overall, compared with normal weight, the summary relative risks of GBC were 1.14 (95% CI, 1.04-1.25) for overweight populations (BMI 25-30 kg/m2) and 1.56 (95% CI, 1.41-1.73) for obese (BMI >30 kg/m2) ones. Obese women had a higher risk of GBC than men did (women: RR 1.67, 95% CI 1.38-2.02, men: RR 1.42, 95% CI 1.21-1.66), and there was a significant association between overweight and GBC risk for women (RR 1.26, 95% CI 1.13-1.40), but not for men (RR 1.06, 95% CI 0.94-1.20). In addition, subgroup analyses revealed that overweight people with smoking or alcohol consumption or in western countries were strongly associated GBC risk (RR 1.16, 95% CI 1.02-1.31 for smokers, RR 1.27, 95% CI 1.10-1.47 for drinkers, and RR 1.14, 95% CI 1.05-1.25). Conclusions:Findings from this meta-analysis indicate that obesity is associated with an increased risk of GBC in both men and women, and overweight is associated with GBC risk only in women.

show abstract

Diabetes mellitus and increased risk of biliary tract cancer: systematic review and meta-analysis

Abstract: These findings strongly support the link between diabetes and increased risk of cancer of biliary tract and its subsites: gallbladder cancer or extrahepatic cholangiocarcinoma, but not cancer of ampulla of Vater.

Cited by 79 publications

References 47 publications

Diabetes mellitus, insulin treatment, diabetes duration, and risk of biliary tract cancer and hepatocellular carcinoma in a European cohort

Diabetes mellitus, insulin treatment, diabetes duration, and risk of biliary tract cancer and hepatocellular carcinoma in a European cohort

Increased Risk of Gastrointestinal Malignancy in Patients with Diabetes Mellitus and Correlations with Anti-Diabetes Drugs: A Nationwide Population-based Study in Taiwan

Body Mass Index and the Risk of Gallbladder Cancer: An Updated Meta-analysis of Epidemiologic Studies

Contact Info

Product

Resources

About