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

Meng, Wei; Hu, Ruying; Wu, Haibin; Pan, Jay; Gong, Weiwei; Guo, Liheng; Zhong, Jieming; Fei, Fang-Rong; Yu, Min

doi:10.1038/srep11503

Cited by 63 publications

(68 citation statements)

References 31 publications

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“…Because cancer risk among patients with T2D may vary by specific cancer site, we systematically investigated 23 common cancers. This study showed a significantly increased risk of overall cancer among patients with T2D, which is consistent with most previous studies . Increased risks were noted for 11 cancers in males, with SIRs ranging from 1.16 to 1.86, and 13 cancers in females, with SIRs ranging from 1.30 to 2.33.…”

Section: Discussionsupporting

confidence: 91%

“…For specific cancer sites, the findings regarding increased risks of stomach, 9,12 colorectal, 17,21,25 liver, 17,21,25 pancreatic, 17,21,25 lung, 17,21,25 and thyroid cancer, 10,25 as well as lymphoma 9,25 and leukemia 17,25 were consistent with some previous studies. In contrast, these results differed from the results of decreased risks reported by other studies.…”

Section: Discussionsupporting

confidence: 90%

“…This study showed a significantly increased risk of overall cancer among patients with T2D, which is consistent with most previous studies. [8][9][10][11][12][13][14][15][16][17][18]21 Increased risks were noted for 11 cancers in males, with SIRs ranging from 1.16 to 1.86, and 13 cancers in females, with SIRs ranging from 1.30 to 2.33.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the association between diabetes and cancer risk depends on the specific cancer site, and results of previously reported epidemiological studies also are inconsistent. Most published studies were performed in Western and Taiwan populations, with only a few studies conducted in mainland China . To elucidate the association between diabetes and cancer risk is particularly important in mainland China; considering the large population and high prevalence of diabetes, even a slight increase in cancer risk may have a significant public health effect at the population level for the country.…”

Section: Introductionmentioning

confidence: 99%

“…Most published studies were performed in Western and Taiwan populations, with only a few studies conducted in mainland China. [14][15][16]21,22 To elucidate the association between diabetes and cancer risk is particularly important in mainland China; considering the large population and high prevalence of diabetes, even a slight increase in cancer risk may have a significant public health effect at the population level for the country. Therefore, this study explored the risk of 23 common cancers among patients with type 2 diabetes (T2D), compared with the general Chinese population, in Shanghai, China.…”

Section: Introductionmentioning

confidence: 99%

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Cancer risk among patients with type 2 diabetes: A real‐world study in Shanghai, China

Jing

Yao

et al. 2019

Journal of Diabetes

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Background The aim of this study was to investigate the risk of 23 common types of cancer among patients with type 2 diabetes (T2D) compared with the general Chinese population. Methods Based on the Shanghai Hospital Link database, 410 191 patients with T2D (age 20‐99 years) were identified from July 2013 to December 2016, and were followed‐up for cancer incidence until December 2017. Results In all, 8485 cases of newly diagnosed cancer were identified. The standardized incidence ratios (SIRs) of total cancer were 1.34 and 1.62 among males and females, respectively. Among males with T2D, the risk of cancer of the prostate (highest SIR of 1.86), blood (leukemia, lymphoma), skin, thyroid, kidney, liver, pancreas, lung, colorectum, and stomach was increased significantly. There was a significant decrease in the risk of esophageal cancer. In females with T2D, there were significantly greater risks of cancer of the nasopharynx (highest SIR of 2.33), liver, esophagus, thyroid, lung, pancreas, blood (lymphoma, leukemia), uterus, colorectum, breast, cervix, and stomach. In contrast, there was significantly decrease risk of gallbladder cancer in females with T2D. Conclusions This study shows significantly increased risks of overall and some site‐specific cancers among patients with T2D. We suggest that establishing strategies for regular cancer‐specific screening and prevention care among patients with T2D are necessary.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cancer risk among patients with type 2 diabetes: A real‐world study in Shanghai, China

Jing

Yao

et al. 2019

Journal of Diabetes

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Diabetes and incidence of breast cancer and its molecular subtypes: A systematic review and meta‐analysis

Xiong,

Dai,

Zhang

et al. 2023

Diabetes Metabolism Res

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Diabetes mellitus (DM) has been proposed to be positively associated with breast cancer (BCa) risk due to shared risk factors, metabolic dysfunction, and the use of antidiabetic medications. We conducted a systematic review and meta‐analysis to evaluate the association between DM and BCa risk. We searched PubMed, Embase, and Web of Science for cohort and case‐control studies assessing the association between DM and BCa published before 10 December 2021. Two reviewers independently screened the studies for inclusion, abstracted article data, and rated study quality. Random effects models were used to estimate summary risk ratios (RRs) and 95% confidence intervals (CIs). From 8396 articles identified in the initial search, 70 independent studies were included in the meta‐analysis. DM was associated with an overall increased risk of BCa (RR = 1.20, 95% CI: 1.11–1.29). The 24 case‐control studies demonstrated a stronger association (RR = 1.26, 95% CI: 1.13–1.40) than the 46 cohort studies (RR = 1.15, 95% CI: 1.05–1.27). Studies reporting risk by menopausal status found that postmenopausal women had an elevated risk of developing BCa (RR = 1.12, 95% CI: 1.07–1.17). No association between DM and BCa risk was observed among premenopausal women (RR = 0.95, 95% CI: 0.85–1.05). In addition, DM was associated with significantly increased risks of oestrogen receptor (ER)+ (RR = 1.09, 95% CI: 1.00–1.20), ER‐ (RR = 1.16, 95% CI: 1.04–1.30), and triple negative BCa (RR = 1.41, 95% CI: 1.01–1.96). The association estimate for human epidermal growth factor 2‐positive BCa was also positive (RR = 1.21, 95% CI: 0.52–2.82), but the CI was wide and crossed the null. Our meta‐analysis confirms a modest positive association between DM and BCa risk. In addition, our results suggest that the association between DM and BCa may be modified by menopausal status, and that DM may be differentially associated with BCa subtypes defined by receptor status. Additional studies are warranted to investigate the mechanisms underlying these associations and any influence of DM on BCa receptor expression.

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Diabetes in midlife and risk of cancer in late life: A nationwide Swedish twin study

Bao

Pedersen

Yang

et al. 2018

Intl Journal of Cancer

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The association between diabetes and cancer risk remains controversial. Hence, we examined whether midlife diabetes is related to the risk of cancer in late-life, and whether genetic and early-life environmental factors play a role in this association. This study included 25,154 twin individuals born in 1958 or earlier from the Swedish Twin Registry. Information on cancer diagnosis in late life (aged ≥ 65) during 1998-2014, was derived from the National Patient and Cancer Registries. Diabetes was ascertained based on self- or informant-reported history, patient registry and antidiabetic medication use. Midlife diabetes was defined when diabetes was diagnosed before 65 years. Data were analyzed following two strategies: (i) unmatched case-control analysis for all participants using generalized estimating equation (GEE) models, and (ii) co-twin control analysis for cancer-discordant twin pairs using conditional logistic regression. Overall, 1,766 (7.0%) had midlife diabetes and 5,293 (21.0%) had cancer in late-life. In multiadjusted GEE models, the odds ratios (95% CIs) of diabetes were 10.55 (2.95-37.67) for pharynx cancer, 5.78 (1.72-19.40) for small intestine cancer, 2.37 (1.14-4.91) for liver cancer and 0.48 (0.35-0.67) for prostate cancer. In people with diabetes, diabetes duration was dose-dependently associated with cancer risk. In conditional logistic regression analysis of 176 prostate cancer-discordant twin pairs, the association between midlife diabetes and prostate cancer in later life became stronger. Midlife diabetes increases the risk of pharynx, small intestine and liver cancers, but reduces prostate cancer risk in late life. Genetic and early-life environmental factors may partially contribute to the diabetes-prostate cancer association.

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

Cited by 63 publications

References 31 publications

Cancer risk among patients with type 2 diabetes: A real‐world study in Shanghai, China

Cancer risk among patients with type 2 diabetes: A real‐world study in Shanghai, China

Diabetes and incidence of breast cancer and its molecular subtypes: A systematic review and meta‐analysis

Diabetes in midlife and risk of cancer in late life: A nationwide Swedish twin study

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