Pre-existing diabetes mellitus and all-cause mortality in cancer patients: a register-based study in Latvia

Strēle, Ieva; Pildava, Santa; Repša, Ilze; Kojalo, Una; Vilmanis, Jānis; Briģis, Ģirts

doi:10.1080/0284186x.2017.1420909

Cited by 9 publications

(12 citation statements)

References 21 publications

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“…Some types of cancer are treated less aggressively in cancer survivors with diabetes than those without diabetes (18). In our study, prediagnosis diabetes increased the risk of all-cause mortality after adjusting for covariables in breast and prostate cancer sites, which is not consistent with previous findings (19,20). But additional evidence indicated that pre-existing diabetes increased the risk of all-cause mortality among women with breast cancer after adjusting for covariables related to delayed diagnosis and therapy (21).…”

Section: Discussioncontrasting

confidence: 99%

“…But additional evidence indicated that pre-existing diabetes increased the risk of all-cause mortality among women with breast cancer after adjusting for covariables related to delayed diagnosis and therapy (21). In addition, pre-diagnosis diabetes increased the risk of allcause mortality in colorectal cancer survivors in our study, which is consistent with findings in previous study (20).…”

Section: Discussionsupporting

confidence: 92%

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Pre- and Post-diagnosis Diabetes as a Risk Factor for All-Cause and Cancer-Specific Mortality in Breast, Prostate, and Colorectal Cancer Survivors: a Prospective Cohort Study

et al. 2020

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Objective: The relationship between diabetes and all-and cause-specific mortality in individuals with common cancers (breast, colorectal, and prostate) remains both under-researched and poorly understood.Methods: Cancer survivors (N = 37,993) from the National Health Interview Survey with linked data retrieved from the National Death Index served as our study participants. Cox proportional-hazards models were used to assess associations between pre-and post-diabetes and all-cause and cause-specific mortality.Results: Over a median follow-up period of 13 years, 2,350 all-cause, 698 cancer, and 506 CVD deaths occurred. Among all cancer survivors, patients with diabetes had greater risk of: all-cause mortality [hazard ratio (HR) 1.35, 95% CI = 1.27-1.43], cancer-specific mortality (HR: 1.14, 95% CI = 1.03-1.27), CVD mortality (HR: 1.36, 95% CI = 1.18-1.55), diabetes related mortality (HR: 17.18, 95% CI = 11.51-25.64), and kidney disease mortality (HR: 2.51, 95% CI = 1.65-3.82), compared with individuals without diabetes. The risk of all-cause mortality was also higher amongst those with diabetes and specific types of cancer: breast cancer (HR: 1.28, 95% CI = 1.12-1.48), prostate cancer (HR: 1.20, 95% CI = 1.03-1.39), and colorectal cancer (HR: 1.29, 95% CI = 1.10-1.50). Diabetes increased the risk of cancer-specific mortality among colorectal cancer survivors (HR: 1.36, 95% CI = 1.04-1.78) compared to those without diabetes. Diabetes was associated with higher risk of diabetes-related mortality when compared to non-diabetic breast (HR: 9.20, 95% CI = 3.60-23.53), prostate (HR: 18.36, 95% CI = 6.01-56.11), and colorectal cancer survivors (HR: 12.18, 95% CI = 4.17-35.58). Both pre-and post-diagnosis diabetes increased the risk of all-cause mortality among Tao et al.Diabetes Reduces Cancer Survival all cancer survivors. Cancer survivors with diabetes had similar risk of all-cause and CVD mortality during the second 5 years of diabetes and above 10 years of diabetes as compared to non-diabetic patients.Conclusions: Diabetes increased the risk of all-cause mortality among breast, prostate, and colorectal cancer survivors, not for pre-or post-diagnosis diabetes. Greater attention on diabetes management is warranted in cancer survivors with diabetes.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 92%

Pre- and Post-diagnosis Diabetes as a Risk Factor for All-Cause and Cancer-Specific Mortality in Breast, Prostate, and Colorectal Cancer Survivors: a Prospective Cohort Study

et al. 2020

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“…One study [ 32 ] only presented a Kaplan Meier curve, from which the number of deaths were estimated and used to calculate a risk estimate and 95% CI using the indirect log hazard ratio and variance estimation method from Parmer et al [ 33 ]. If studies presented results separately by endometrial cancer histology type (two studies [ 34 , 35 ]), race (two studies [ 19 , 21 ]) or follow-up time (one study [ 36 ]) these estimates were combined using a fixed effects model to produce one estimate before entering into the meta-analysis model[ 37 ]. As there was an overlap between the populations in two studies assessing endometrial cancer-specific survival, separate results were taken according to race; the Olson et al [ 21 ] study was restricted to black endometrial cancer patients whilst the Lam et al [ 38 ] study was restricted to white endometrial cancer patients, and treated separately.…”

Section: Discussionmentioning

confidence: 99%

“…As there was an overlap between the populations in two studies assessing endometrial cancer-specific survival, separate results were taken according to race; the Olson et al [ 21 ] study was restricted to black endometrial cancer patients whilst the Lam et al [ 38 ] study was restricted to white endometrial cancer patients, and treated separately. Additionally, one study [ 36 ] reported outcomes for endometrial cancer patients identified by two methods (cancer registry and National Health Service) and to avoid potential overlap in patients, only the risk estimate from patients identified from the cancer registry were included in the meta-analysis as this is deemed to be a higher quality source for cancer case identification [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Survival outcomes in endometrial cancer patients according to diabetes: a systematic review and meta-analysis

et al. 2022

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Background Diabetes is an established risk factor for endometrial cancer development but its impact on prognosis is unclear and epidemiological studies to date have produced inconsistent results. We aimed to conduct the first systematic review and meta-analysis to compare survival outcomes in endometrial cancer patients with and without pre-existing diabetes. Methods We conducted a systematic search of MEDLINE, EMBASE and Web of Science databases up to February 2022 for observational studies that investigated the association between pre-existing diabetes and cancer-specific survival in endometrial cancer patients. Secondary outcomes included overall survival and progression or recurrence-free survival. Quality assessment of included studies was undertaken using the Newcastle–Ottawa Scale and a random-effects model was used to produce pooled hazard ratios (HRs) and 95% confidence intervals (CIs). (PROSPERO 2020 CRD42020196088). Results In total, 31 studies were identified comprising 55,475 endometrial cancer patients. Pooled results suggested a worse cancer-specific survival in patients with compared to patients without diabetes (n = 17 studies, HR 1.15, 95% CI 1.00–1.32, I2 = 62%). Similar results were observed for progression or recurrence-free survival (n = 6 studies, HR 1.23, 95% CI 1.02–1.47, I2 = 0%) and for overall survival (n = 24 studies, HR 1.42, 95% CI 1.31–1.54, I2 = 46%). Conclusion In this systematic review and meta-analysis, we show that diabetes is associated with a worse cancer-specific and overall survival in endometrial cancer patients.

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“…The present study identified twelve national clinical diabetes registries spread over four different continents, mostly concentrated in the Northern part of Europe [13,14,57,[65][66][67][68][69][70][71][72]. Altogether, these databases comprised a total of 7,181,356 diabetic patients.…”

Section: Discussionmentioning

confidence: 99%

National diabetes registries: do they make a difference?

et al. 2020

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Aims The global epidemic of diabetes mellitus continues to expand, including its large impact on national health care. Measuring diabetes outcomes and their causes of variation highlights areas for improvement in care and efficiency gains; large registries carry this potential. By means of a systematic review, we aimed to give an overview of national registries worldwide by quantifying their data and assessing their influence on diabetes care. Methods The literature on MEDLINE up to March 31, 2020, was searched, using keywords diabetes mellitus, national, registry, registration, and/or database. National disease-specific registries from corresponding articles were included. Database characteristics and clinical variables were obtained. All registries were compared to the ICHOM standard set of outcomes. Results We identified 12 national clinical diabetes registries, comprising a total of 7,181,356 diabetic patients worldwide. Nearly all registries recorded weight, HbA1c, lipid profile, and insulin treatment; the recording of other variables varied to a great extent. Overall, registries corresponded fairly well with the ICHOM set. Most registries proved to monitor and improve the quality of diabetes care using guidelines as a benchmark. The effects on national healthcare policy were more variable and often less clear. Conclusions National diabetes registries confer clear insights into diagnostics, complications, and treatment. The extent to which registries influenced national healthcare policy was less clear. A globally implemented standard outcome set has the potential to improve concordance between national registries, enhance the comparison and exchange of diabetes outcomes, and allocate resources and interventions where most needed.

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Pre-existing diabetes mellitus and all-cause mortality in cancer patients: a register-based study in Latvia

Abstract: Interestingly, we found better overall survival of diabetic men during the first years after cancer diagnosis. We hypothesize that access to health services may be advantageous to diabetic patients who are in close contact with the healthcare system.

Cited by 9 publications

References 21 publications

Pre- and Post-diagnosis Diabetes as a Risk Factor for All-Cause and Cancer-Specific Mortality in Breast, Prostate, and Colorectal Cancer Survivors: a Prospective Cohort Study

Pre- and Post-diagnosis Diabetes as a Risk Factor for All-Cause and Cancer-Specific Mortality in Breast, Prostate, and Colorectal Cancer Survivors: a Prospective Cohort Study

Survival outcomes in endometrial cancer patients according to diabetes: a systematic review and meta-analysis

National diabetes registries: do they make a difference?

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