Incidence and predictors of all-cause and site-specific cancer in type 2 diabetes: the Fremantle Diabetes Study

Abstract

Objective: To explore the relationship between diabetes and cancer. Design: The Fremantle Diabetes Study (FDS) was a community-based longitudinal observational study of 1426 subjects, 1294 of which had type 2 diabetes. Methods: The FDS type 2 cohort and four age-, sex-and postcode-matched controls per case were followed for cancer events from 1993 until mid-2010 and incidence rate ratios (IRRs) were calculated. Competing risks proportional hazards models generated risk factors for incident cancers in the diabetic group. Results: There were 309 first cancers over 13 051 patient-years, or 2368 (95% confidence interval (95% CI) 2111-2647)/100 000 patient-years in the diabetes patients vs 1131 over 60 324 patient-years (1875 (1769-1987)/100 000 patient-years) in the controls. For those aged R45 years, the risk of all-cause cancer was elevated in type 2 diabetic men (IRRs 1.23, 95% CI 1.04-1.45) and women (1.30, 1.06-1.59). The incidence of colorectal cancer was increased (1.36, 1.01-1.82), especially in diabetic men aged 75-84 years (2.14, 1.22-3.64). Age at diabetes diagnosis (sub-hazard ratio 1.05, 1.02-1.09), calcium channel blocker therapy (2.37, 1.39-4.06), recent exercise (2.11, 1.06-4.20) and serum total cholesterol (0.68, 0.52-0.88) increased colorectal cancer risk. Pancreatic cancer was also more frequent in the diabetic patients (IRR 2.26,. Diabetic men and women had similar risks of prostate and breast cancer to those of controls (0.83, 0.59-1.14 and 0.86, 0.52-1.36). Conclusions: Type 2 diabetes is associated with a moderately increased cancer risk in well-characterised community-based patients, especially pancreatic cancer and colorectal cancer in older men. Recommended cancer screening should be considered as part of routine diabetes management.

Calcium channel blockers and breast cancer incidence: An updated systematic review and meta-analysis of the evidence

“…This review had several limitations. Whilst the selection criteria for the review were broad, they did not allow inclusion of data from papers looking at cancer and CCBs, where either breast cancer was not isolated as an outcome, or CCBs as the exposure (68)(69)(70)(71)(72)(73)(74). It is possible that this may have also led to some RCTs being omitted, though reviewing references of a recent systematic review and meta-analysis of relevant RCTs indicates that no eligible studies were missed (75).…”

Incidence and Predictors of Hospitalization for Bacterial Infection in Community-Based Patients with Type 2 Diabetes: The Fremantle Diabetes Study

“…Four age-, sex- and zip-code-matched non-diabetic controls were randomly selected from this source for each participant at the time of FDS1 study entry [25]. The requirement for zip-code matching was based on the fact that there are substantial socio-economic and environmental differences between residential districts within the FDS1 catchment area.…”

miRNA‐30e regulates abnormal differentiation of small intestinal epithelial cells in diabetic mice by downregulating Dll4 expression

“…Previous studies have revealed significant changes to intestinal epithelial cells (IECs) in DM rats (12,13). Recently, researchers have found that changes leading to colorectal cancer may be closely related to DM (14,15), supporting the hypothesis that there is a relationship between DM and abnormal differentiation of IECs.…”