Increased Breast and Colorectal Cancer Risk in Type 2 Diabetes: Awareness Among Adults With and Without Diabetes and Information Provision on Diabetes Websites

Abstract

Background People with type 2 diabetes mellitus (T2DM) have a higher risk of developing breast and bowel cancers but are less likely to participate in cancer screening. Purpose Two interlinked studies examined public awareness of the fact that T2DM increases breast and bowel cancer risk, and provision of this information on diabetes websites. Methods Study-1: phase-1 surveyed awareness of T2DM-increased cancer risk in a nationally-representative British sample aged 50–74 (N = 1,458) and compared respondents with and without T2DM (n = 125 vs. n = 1,305); phase-2 surveyed an additional exclusively T2DM sample (N = 319). Study-2: High-ranking diabetes websites (N = 25) were reviewed to determine the rate of inclusion of cancer risk and cancer screening information in evident sections about diabetes-related health conditions. Results A low proportion of respondents were aware that T2DM increases risk of breast (13.7%) and bowel (27.6%) cancers, compared to much higher awareness of other diabetes-related conditions such as sight loss (82.2%) and foot problems (81.8%). Respondents with T2DM were significantly more likely than those without T2DM to be aware of all the surveyed diabetes-related health conditions (e.g., sight loss, OR: 3.14, 95%CI: 1.61–6.15; foot problems, OR: 2.58, 95%CI: 1.38–4.81), except breast (OR: 0.82, 95%CI: 0.46–1.45) and bowel (OR: 0.95, 95%CI: 0.63–1.45) cancer, for which awareness was equally low among people with and without T2DM. Few diabetes websites with a section on diabetes-related health conditions included cancer in this section (n = 4/19), and fewer still included cancer screening among any noted cancer-protective behaviors (n = 2/4). Conclusions There is low public awareness that T2DM increases the risk of developing breast and bowel cancers, even among people with T2DM, which may be partly due to limited information provision regarding T2DM-increased cancer risk from diabetes care providers and organizations.

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“…He added: 'There's a low public awareness, even among those with the condition, that T2DM increases the risk of developing breast and colorectal cancer. 8 'Recently, information was published to show that because the rates of CVD have really plummeted, it is no longer the predominant cause of premature death in people with diabetes: it's cancer. 9 So, we need to be thinking about educating the people who look after them that it's more about the risk of cancer, not just CVD.…”

“…He added: ‘There's a low public awareness, even among those with the condition, that T2DM increases the risk of developing breast and colorectal cancer 8 …”

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“… 3 , 13 , 14 Furthermore, people with DM may face other barriers to managing their health, including health literacy, beliefs, financial resources, social support, culture, and language. 15 , 16 …”