Diabetes mellitus and risk of gastric cancer

Ge, Zhenming; Ben, Qiwen; Qian, Jingjing; Wang, Yamin; Li, Yuming

doi:10.1097/meg.0b013e32834b8d73

Cited by 72 publications

(33 citation statements)

References 56 publications

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“…However, male diabetes patients seem to be have a reduced risk of prostate cancer (RR= 0.85; 95% CI 0.80-0.91), which support the previous findings [9,10]. Furthermore, our findings support an increased risk of gastric and stomach cancer (RR=1.13; 95% CI 1.02-1.24), whereas former reports have been conflicting [15,16]. An elevation in thyroid cancer (RR=1.27; 95% CI 1.12-1.43) was also present among diabetes patients.…”

Section: Discussionsupporting

confidence: 89%

“…Several observational studies have examined the relationship between diabetes and gastrointestinal cancers. Results were conflicting in the meta-analyses on gastric cancer [15,16], while an increased risk of esophageal cancer was reported [13]. In addition, diabetes has been associated with an increased risk of colorectal cancer [17-19, 21-23] after adjustment for BMI and smoking [20].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it is important both to take obesity into account and to distinguish between type 1 diabetes (T1D) and T2D, which have not been done in previous reports. Except from Ge et al [16] (using three databases), none of the meta-analyses described in the introduction have used more than two databases in their search (Medline at PubMed and Embase/ Medline at PubMed and Cochrane database of systematic reviews), and many only used Medline at PubMed leaving them with a possible publication bias.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

CARING (CAncer Risk and INsulin analoGues): The Association of Diabetes Mellitus and Cancer Risk with Focus on Possible Determinants - A Systematic Review and a Meta-Analysis

Starup-Linde

Karlstad

Eriksen

et al. 2013

CDS

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Background: Patients suffering from diabetes mellitus (DM) may experience an increased risk of cancer; however, it is not certain whether this effect is due to diabetes per se.Objective: To examine the association between DM and cancers by a systematic review and meta-analysis according to the PRISMA guidelines.Data Sources: The systematic literature search includes Medline at PubMed, Embase, Cinahl, Bibliotek.dk, Cochrane library, Web of Science and SveMed+ with the search terms: “Diabetes mellitus”, “Neoplasms”, and “Risk of cancer”.Study Eligibility Criteria: The included studies compared the risk of cancer in diabetic patients versus non-diabetic patients. All types of observational study designs were included.Results: Diabetes patients were at a substantially increased risk of liver (RR=2.1), and pancreas (RR=2.2) cancer. Modestly elevated significant risks were also found for ovary (RR=1.2), breast (RR=1.1), cervix (RR=1.3), endometrial (RR=1.4), several digestive tract (RR=1.1-1.5), kidney (RR=1.4), and bladder cancer (RR=1.1). The findings were similar for men and women, and unrelated to study design. Meta-regression analyses showed limited effect modification of body mass index, and possible effect modification of age, gender, with some influence of study characteristics (population source, cancer- and diabetes ascertainment).Limitations: Publication bias seemed to be present. Only published data were used in the analyses.Conclusions: The systematic review and meta-analysis confirm the previous results of increased cancer risk in diabetes and extend this to additional cancer sites. Physicians in contact with patients with diabetes should be aware that diabetes patients are at an increased risk of cancer.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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CARING (CAncer Risk and INsulin analoGues): The Association of Diabetes Mellitus and Cancer Risk with Focus on Possible Determinants - A Systematic Review and a Meta-Analysis

Starup-Linde

Karlstad

Eriksen

et al. 2013

CDS

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“…Among Asian population, except for Japanese population with a high incidence of this malignancy22, a modest increased risk of stomach cancer was observed in a study involving 895,434 T2DM patients in Taiwan15. Our analysis only showed a significant increased cancer risk in females, comparable to a recent meta-analysis of seventeen cohort studies and four case-control studies23 and a more recent meta-analysis of eleven cohort studies and six case-control studies24. Esophageal cancer showed a decreased risk in T2DM patients, which were consistent with findings from Asian population1525 and Australian females10.…”

Section: Discussionsupporting

confidence: 79%

Cancer risk among patients with type 2 diabetes mellitus: a population-based prospective study in China

Meng

et al. 2015

Sci Rep

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Evidence indicates an increased cancer risk among type 2 diabetes mellitus (T2DM) patients, yet studies in mainland China are scarce. Based on Diabetes Surveillance System linking to Cancer Surveillance System of Zhejiang Province in China, we explored the cancer risk among T2DM patients. Totally, 327,268 T2DM patients were identified and followed from January 1, 2007 to December 31, 2013. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were reported. Overall cancer risk was found significantly increased with an SIR of 1.15 (95% CI 1.12–1.19) and 1.25 (95% CI 1.21–1.30) in males and females, respectively. Regarding specific cancer sites, risks of liver, colon, rectum, pancreas, and kidney were significantly increased with SIRs of 1.26 (95% CI 1.16–1.36), 1.47 (95% CI 1.29–1.67), 1.25 (95% CI 1.09–1.43), 2.81 (95% CI 2.50–3.16) and 1.61 (95% CI 1.28–2.03) in males, 1.53 (95% CI 1.35–1.73), 1.33 (95% CI 1.15–1.54), 1.29 (95% CI 1.10–1.51), 3.62 (95% CI 3.20–4.09) and 1.71 (95% CI 1.28–2.29) in females, respectively. A significant increased SIR was noted for prostate (1.80, 95% CI 1.58–2.06). Significant increased SIRs for lung (1.32, 95% CI 1.20–1.44) and stomach (1.16, 95% CI 1.03–1.30) were observed in females. We suggested an increased cancer risk among T2DM patients.

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“…More recently, DM has been shown to be associated with an increase in cancer risk by epidemiologic and mechanistic studies [3]. Observational studies have demonstrated increased risks of cancers of the pancreas [4], colon and rectum [5], esophagus [6], stomach [7], liver and bile ducts [8,9], urinary tract [10], breast [11], and the endometrium [12–16] among patients with DM. Moreover, DM and increased serum glucose concentration have been associated with a rise in cancer-related mortality compared to the general population [17–19].…”

Section: Introductionmentioning

confidence: 99%

Is diabetes mellitus associated with increased incidence and disease-specific mortality in endometrial cancer? A systematic review and meta-analysis of cohort studies

Liao

Zhang

Mungo

et al. 2014

Gynecologic Oncology

124

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Objective To assess the association between diabetes mellitus (DM) and the incidence and disease-specific mortality of endometrial cancer (EC). Methods MEDLINE, EMBASE and conference abstracts of the 2011–2013 Annual Meetings of Society of Gynecological Oncology were searched for reports of original cohort studies that enrolled diabetic and non-diabetic women who were free of EC at baseline to compare the incidence and disease-specific mortality of EC by DM status. The included reports were examined for demographic characteristics of study populations, study design, effect measures and risk of bias. Statistical heterogeneity was evaluated with Chi-square test of the Cochrane Q statistics at the 0.05 significance level and I2 statistic. Publication bias was assessed by visual examination of a funnel plot and the Egger’s test for small-study effects. Results Twenty-nine cohort studies (17 prospective, 12 retrospective) were eligible for this review, 23 of which reported EC incidence, five reported disease-specific mortality and one reported both. For incidence of EC among women with versus without DM, the summary relative risk (RR) was 1.89 (95%CI, 1.46–2.45; p < 0.001) and the summary incidence rate ratio was 1.61 (95%CI, 1.51–1.71; p < 0.001). The pooled RR of disease-specific mortality was 1.32 (95%CI, 1.10–1.60; p = 0.003), while results in the studies reporting standardized mortality ratios were inconsistent. There remains considerable amount of clinical and methodological heterogeneity among the included studies; moreover, the hazard ratios for incident EC showed significant statistical heterogeneity and therefore were not quantitatively synthesized. Conclusions There is consistent evidence for an independent association between DM and an increased risk of incident EC, while the association between DM and EC-specific mortality remains uncertain. Further studies with better considerations for selection bias, information bias and confounding will further facilitate causal inference involving DM and EC.

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Diabetes mellitus and risk of gastric cancer

Abstract: These findings of this systematic review indicate that compared with nondiabetic individuals, diabetic women have an 18% increased risk of GC development. However, diabetic men have a similar risk of GC.

Cited by 72 publications

References 56 publications

CARING (CAncer Risk and INsulin analoGues): The Association of Diabetes Mellitus and Cancer Risk with Focus on Possible Determinants - A Systematic Review and a Meta-Analysis

CARING (CAncer Risk and INsulin analoGues): The Association of Diabetes Mellitus and Cancer Risk with Focus on Possible Determinants - A Systematic Review and a Meta-Analysis

Cancer risk among patients with type 2 diabetes mellitus: a population-based prospective study in China

Is diabetes mellitus associated with increased incidence and disease-specific mortality in endometrial cancer? A systematic review and meta-analysis of cohort studies

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