Impact of metabolic factors on subsequent cancer risk: results from a large-scale population-based cohort study in Japan

Abstract

The impact of metabolic factors, which are major risk factors for cardiovascular disease, on total cancer risk has not been clarified. We prospectively examined whether metabolic factors and their aggregates predict the subsequent occurrence of total and major sites of cancer in the Japan Public Health Center-based Prospective Study. A total of 27 724 participants (9548 men and 18 176 women) aged 40-69 years participating in a questionnaire and health checkup survey in 1993-1995 were followed for total cancer incidence through 2004. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated for metabolic factors and for two criteria of their aggregates (three or more than three factors and two or more than two additional factors in addition to being overweight) with a Cox proportional hazards model to control for potential confounding factors. In both sexes, the presence of metabolic factors in the aggregate did not predict subsequent occurrence of cancer as a whole. By site, a significant increase in risk was observed for male liver cancer [HR = 1.73, CI = 1.03-2.91 (three or more than three factors); HR = 1.99, CI = 1.11-3.58 (two or more than two additional factors in addition to being overweight)], and female pancreatic cancer [HR = 1.99, CI = 1.00-3.96 (two or more than two additional factors in addition to being overweight)]. For other sites, positive associations were observed only for specific metabolic factors, that is, high triglycerides and male colon cancer (HR = 1.71, CI = 1.11-2.62), and obesity and female breast cancer (HR = 1.75, CI = 1.21-2.55). Metabolic factors in the aggregate may have little impact on total cancer risk in the Japanese population, although the association between specific components and specific cancers suggests an etiologic link between them.

The association between serum lipids and colorectal neoplasm: a systemic review and meta-analysis

“…Nine studies were conducted in the USA (16,18,20,32,35,(37)(38)(39)(40) , one in Sweden (42) , five in Korea (6,9,10,22,27) , two in China (23,30) , eight in Japan (8,24,26,28,29,31,36,43) , one in Austria (41) and three in European countries (4,17,34) (Tables 1 and 2). Pooled analysis showed a significant association between serum TAG and CRN (n 29 studies; summary RR = 1·08; 95 % CI 1·05, 1·12, P < 0·00001; Fig.…”

Age- and Sex-Specific Risks of Colorectal Cancers in Diabetic Patients

“…Some of the previous studies reported that diabetes was associated with increased risk of colon cancer but not rectal cancer in both men and women (Le Marchand et al 1997;Yang et al 2004). Other studies (Wideroff et al 1997;Inoue et al 2006;Limburg et al 2006) indicated that diabetes is positively associated with the development of colon cancer in men but not diabetic women, and that diabetes in both the sexes is not associated with the development of rectal cancer. The discrepancy across the results of these studies is probably due to different methodologies that were adopted, including dissimilarity in the baseline characteristics and ethnicities of the patients, in methods of outcome assessment, and duration of follow-up.…”

“…Indeed, there is a discrepancy in the results reported for sex-and age-specific incidence and relative hazard ratio of colorectal cancer. Some of the previous studies have reported that both male and female diabetic patients are at high risk of developing colorectal cancer (Le Marchand et al 1997;Weiderpass et al 1997;Yang et al 2004), whereas some other studies have shown that the risk of developing colorectal cancer is high in either diabetic men alone (Adami et al 1991;Wideroff, L. et al 1997;Khaw et al 2004;Limburg et al 2006;Inoue et al 2006) or diabetic women alone (Nilsen and Vatten 2001). The inconsistency in age-and sex-specific results of previous studies may be attributable to dissimilarities in patient characteristics, care received by the study patients, and possibly, differential accuracy of diagnosis.…”

“…© 2012 Nearly one million newly diagnosed colorectal cancer cases are reported to occur in 2002 globally, which accounted for approximately 10% of all incident cancer (Parkin et al 2005). Many studies have reported that diabetes, which is associated with obesity and physical inactivity, increases the risk of colorectal cancer (Adami et al 1991;Le Marchand et al 1997;Weiderpass et al 1997;Wideroff et al 1997;Will et al 1998;Khaw et al 2004;Limburg et al 2005;Larsson et al 2005aLarsson et al , 2005bLimburg et al 2006;Inoue et al 2006), but some studies have not reported any association (O'Mara et al 1985;Kune et al 1988;La Vecchia et al 1994;Steenland et al 1995). Indeed, there is a discrepancy in the results reported for sex-and age-specific incidence and relative hazard ratio of colorectal cancer.…”

Is Diabetes a Risk Factor for Colorectal Cancer?

“…In the Cancer Prevention Study II Nutrition Cohort, Campbell et al [8] found a moderate increase in risk of colorectal cancer among men with diabetes (pooled RR = 1.24; 95 % CI 1.08-1.44), but no such association among women. Inoue et al [9] using the Japan Public Health Center-Based Prospective Study, observed no increase in risk of colon cancer with diabetes after excluding cancer cases diagnosed within 5 years of diagnosis of diabetes (HR = 1.19, 95 % CI 0.91-1.55 for men and 1.14, 95 % CI 0.70-1.87 for women). Similarly, data from the Japan Collaborative Cohort (JACC) showed no statistically significant increased risk of colorectal cancer with diabetes (IRR = 1.37, 95 % CI 0.95-1.96) [10].…”