Modest increase in risk of specific types of cancer types in type 2 diabetes mellitus patients

Lo, Sui-Foon; Chang, Shang‐Tzen; Muo, Chih‐Hsin; Chen, Shih Yin; Liao, Fang-Yin; Dee, Shu-Wei; Chen, Pei–Chun; Sung, Fung‐Chang

doi:10.1002/ijc.27597

Cited by 70 publications

(80 citation statements)

References 33 publications

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“…As biological evidence, a dose-response meta-analysis revealed that every 0.56 mmol/L increase in fasting blood glucose was associated with a 14% increase in the rate of pancreatic cancer13. Although the association between T2DM and lung cancer has been suggested, the conclusions were inconsistent in studies1415161718. Overall, our findings supported the hypothesis that the risk of developing lung cancer increase in T2DM patients, particularly among women.…”

Section: Discussionsupporting

confidence: 72%

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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Section: Discussionsupporting

confidence: 72%

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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“…Because of differences in apparent relationships between diabetes and the various types of malignancy, analyses of associations with all-cause cancers have been discouraged (8). However, the consistency of the results of this and other studies (22,23,24,26,27) suggests that there is a moderate diabetes-specific increase in overall cancer risk. Possible unifying underlying mechanisms include direct promotion of cell growth and an increase in the likelihood of metastasis through altered endothelial permeability by hyperglycaemia (28), while hyperinsulinaemia and elevated circulating insulin-like growth factor concentrations may also promote tumour growth (29).…”

Section: Discussionmentioning

confidence: 78%

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

Magliano

Davis

Shaw

et al. 2012

European Journal of Endocrinology

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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.

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“…Ten case-control studies 3,19-27 and 14 cohort studies 4,10,11,[28][29][30][31][32][33][34][35][36][37][38] were included in the meta-analysis. Analysis of all studies showed that, compared with individuals without DM, those with DM had a statistically significant increased risk of bladder cancer (RR 1.30, 95% CI 1.18-1.43) (Fig.…”

Section: Dm and Bladder Cancer Riskmentioning

confidence: 99%

Diabetes Mellitus Increases the Risk of Bladder Cancer: An Updated Meta-Analysis of Observational Studies

Fang

Yao

Yan

et al. 2013

Diabetes Technology & Therapeutics

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Background: Increasing evidence suggests that diabetes mellitus (DM) may be associated with an increased risk of bladder cancer. We performed an updated meta-analysis to examine the association between DM and risk of bladder cancer. Materials and Methods: We systematically searched the EMBASE and Medline (PubMed) databases (from inception through February 1, 2013) and reviewed the reference lists of relevant publications to search for additional studies. Summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated with random-effects models. Results: In total, 10 case-control and 14 cohort studies met the inclusion criteria. Analysis of all studies showed that DM was associated with an increased risk of bladder cancer (RR 1.30, 95% CI 1.18-1.43). There was heterogeneity among studies (P heterogeneity < 0.001, I 2 = 81.5%). Cohort studies showed a lower risk (RR 1.23, 95% CI 1.09-1.37) than case-control studies (odds ratio 1.46, 95% CI 1.20-1.78). The positive association was significant only in women (RR 1.23, 95% CI 1.02-1.49), but not in men (RR 1.07, 95% CI 0.97-1.18). The combined RRs remained unchanged before and after the studies on type 1 diabetes were excluded from analysis. The association between DM and bladder cancer risk did not differ significantly by methods of DM ascertainment. The combined RRs were 1.17 (95% CI 1.03-1.34), 1.34 (95% CI 1.19-1.51), and 1.57 (95% CI 0.96-2.55), respectively, when restricting the analysis to the studies accounting for body mass index, cigarette smoking, or glucose-lowering drug use. Conclusions: This meta-analysis indicates a positive association between DM and risk of bladder cancer. Further studies are warranted to determine whether DM prevention and control can reduce risk of bladder cancer.

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Modest increase in risk of specific types of cancer types in type 2 diabetes mellitus patients

Cited by 70 publications

References 33 publications

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

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

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

Diabetes Mellitus Increases the Risk of Bladder Cancer: An Updated Meta-Analysis of Observational Studies

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