Ethnic Differences in Cancer Rates Among Adults With Type 2 Diabetes in New Zealand From 1994 to 2018

Yu, Dahai; Wang, Zheng; Cai, Yamei; McBride, Kate A; Osuagwu, Uchechukwu L.; Pickering, Karen; Baker, John; Cutfield, Richard; Orr-Walker, Brandon; Sundborn, Gerhard; Jameson, Michael B.; Zhao, Zhanzheng; Simmons, David

doi:10.1001/jamanetworkopen.2021.47171

Cited by 7 publications

(5 citation statements)

References 27 publications

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“…Additionally, we accounted for the presence of treatments such as antihypertensive, anticoagulant, and lipid‐lowering drugs by index date. To assess the socioeconomic status of participants, we utilized the NZDep2013 Index of Deprivation, which assigns an Index of Multiple Deprivation (IMD) score to each meshblock in New Zealand based on the distribution of the first principal component scores 20 . The IMD score ranges from 1 to 10, with lower scores indicating lower levels of deprivation.…”

Section: Methodsmentioning

confidence: 99%

“…To assess the socioeconomic status of participants, we utilized the NZDep2013 Index of Deprivation, which assigns an Index of Multiple Deprivation (IMD) score to each meshblock in New Zealand based on the distribution of the first principal component scores. 20 The IMD score ranges from 1 to 10, with lower scores indicating lower levels of deprivation. To ensure sufficient statistical power, we categorized the IMD into five groups: IMD‐1 (least deprived: NZDep2013 scores of 1–2), IMD‐2, IMD‐3, IMD‐4 (scores of 3–4, 5–6, and 7–8, respectively), and IMD‐5 (most deprived: scores of 9–10).…”

Section: Methodsmentioning

confidence: 99%

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Long‐term impact of type 2 diabetes onset on dementia incidence rate among New Zealanders with impaired glucose tolerance: A tapered‐matched landmark analysis over 25 years

Yu,

Wang,

Osuagwu

et al. 2024

Alzheimer's & Dementia

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INTRODUCTIONWe aimed to investigate the association between the onset of type 2 diabetes (T2D) and dementia incidence rates (IR) in the population with impaired glucose tolerance (IGT) identified in primary care in New Zealand (NZ) over 25 years.METHODSTapered matching and landmark analysis (accounting for immortal bias) were used to control for potential effects of known confounders. The association between T2D onset and 5‐ and 10‐year IR of dementia was estimated by weighted Cox models.RESULTSThe onset of T2D was significantly associated with the 10‐year IR of dementia, especially in the socioeconomically deprived, those of non‐NZ European ethnicity, those currently smoking, and patients with higher metabolic measures.DISCUSSIONOur findings suggest that the onset of T2D is a significant risk factor for dementia in individuals with IGT. Dementia screening and structured diabetes prevention are vital in the population with IGT, particularly those from deprived or ethnic minority backgrounds.Highlights Increased dementia incidence rate links with T2D onset in people with IGT. Significant incidence varied by ethnicity, socioeconomic status, and health factors. Results emphasize the diabetes manage and socioeconomic factors on dementia risk. Secondary analysis highlights the key role of vascular health in dementia prevention.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Long‐term impact of type 2 diabetes onset on dementia incidence rate among New Zealanders with impaired glucose tolerance: A tapered‐matched landmark analysis over 25 years

Yu,

Wang,

Osuagwu

et al. 2024

Alzheimer's & Dementia

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“…Socioeconomic status was determined using the NZDep2013 Index of Deprivation, which measures the level of deprivation in a given area. 22 The NZDep2013 assigns an Index of Multiple Deprivation (IMD) score for each New Zealand meshblock (geographic unit containing a median of 81 people). 22 Scores on the NZDep2013 scale of deprivation range from 1 to 10, with lower scores indicating less deprivation; the scale divides New Zealand into tenths of the distribution of the first principal component scores and was consistent with prior deprivation measures.…”

Section: Methodsmentioning

confidence: 99%

“… 22 The NZDep2013 assigns an Index of Multiple Deprivation (IMD) score for each New Zealand meshblock (geographic unit containing a median of 81 people). 22 Scores on the NZDep2013 scale of deprivation range from 1 to 10, with lower scores indicating less deprivation; the scale divides New Zealand into tenths of the distribution of the first principal component scores and was consistent with prior deprivation measures. 23 To maintain statistical power, the IMD was recategorized into 5 groups: IMD‐1 (least deprived: NZDep2013 scores of 1–2); IMD‐2, IMD‐3, and IMD‐4 (NZDep2013 scores of 3–4, 5–6, and 7–8, respectively); and IMD‐5 (most deprived: NZDep2013 scores of 9–10).…”

Section: Methodsmentioning

confidence: 99%

Association Between Onset of Type 2 Diabetes and Risk of Atrial Fibrillation in New Zealanders With Impaired Glucose Tolerance Over 25 Years

Yu,

Qu,

Osuagwu

et al. 2023

JAHA

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Background The association between the onset of type 2 diabetes (T2D) and atrial fibrillation (AF) risk in individuals with impaired glucose tolerance (IGT) remains unclear. This study aimed to investigate the relationship between the incident onset of T2D and 5‐ and 10‐year (after the landmark period) risks of AF in people with IGT identified in South and West Auckland primary care settings between 1994 and 2019. Methods and Results We compared AF risk in patients with IGT with and without newly diagnosed T2D within a 1‐ to 5‐year exposure window. Tapered matching and landmark analysis (to address immortal bias) were used to control for confounding variables. The cohorts incorporated 785 patients who had T2D newly diagnosed within 5 years from enrollment (landmark date) and 15 079 patients without a T2D diagnosis. Patients progressing to T2D exhibited significantly higher 5‐year (after the landmark period) AF risk (hazard ratio [HR], 1.34 [95% CI, 1.10–1.63]) and 10‐year (after the landmark period) AF risk (HR, 1.28 [95% CI, 1.02–1.62]) compared with those without incident T2D. The association was more pronounced among men, older patients, socioeconomically deprived individuals, current smokers, those with higher metabolic measures, and lower renal function. New Zealand European ethnicity was associated with a lower 5‐ and 10‐year risk of AF. Conclusions This study found a mediating effect of T2D on the risk of AF in a population with IGT in New Zealand. The development of risk scores and future replication studies can help identify and guide management of individuals with IGT at the highest risk of AF following incident T2D.

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“…As Māori and Pacific populations are disproportionately affected by both diabetes and cancer, we might expect the burden of cancer and diabetes co-occurrence to be greater for these population groups. 17 However, prevalence data for cancer and diabetes co-occurrence in NZ are limited, with most evidence coming from clinical audits with limited sample sizes, 18 - 20 regional investigations, 17 or national investigations that used only hospitalization records to define diabetes status (with low sensitivity and hence underascertainment of diabetes). 21 Robust national evidence of ethnic differences in the likelihood of cancer diagnosis among those with and without diabetes, stratified by cancer, is urgently needed.…”

Section: Introductionmentioning

confidence: 99%

Equity of Cancer and Diabetes Co-Occurrence: A National Study With 44 Million Person-Years of Follow-Up

Gurney

Stanley

Teng

et al. 2023

JCO Global Oncology

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PURPOSE The co-occurrence of diabetes and cancer is becoming increasingly common, and this is likely to compound existing inequities in outcomes from both conditions within populations. METHODS In this study, we investigate the co-occurrence of cancer and diabetes by ethnic groups in New Zealand. National-level diabetes and cancer data on nearly five million individuals over 44 million person-years were used to describe the rate of cancer in a national prevalent cohort of peoples with diabetes versus those without diabetes, by ethnic group (Māori, Pacific, South Asian, Other Asian, and European peoples). RESULTS The rate of cancer was greater for those with diabetes regardless of ethnic group (age-adjusted rate ratios, Māori, 1.37; 95% CI, 1.33 to 1.42; Pacific, 1.35; 95% CI, 1.28 to 1.43; South Asian, 1.23; 95% CI, 1.12 to 1.36; Other Asian, 1.31; 95% CI, 1.21 to 1.43; European, 1.29; 95% CI, 1.27 to 1.31). Māori had the highest rate of diabetes and cancer co-occurrence. Rates of GI, endocrine, and obesity-related cancers comprised a bulk of the excess cancers occurring among Māori and Pacific peoples with diabetes. CONCLUSION Our observations reinforce the need for the primordial prevention of risk factors that are shared between diabetes and cancer. Also, the commonality of diabetes and cancer co-occurrence, particularly for Māori, reinforces the need for a multidisciplinary, joined-up approach to the detection and care of both conditions. Given the disproportionate burden of diabetes and those cancers that share risk factors with diabetes, action in these areas is likely to reduce ethnic inequities in outcomes from both conditions.

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Ethnic Differences in Cancer Rates Among Adults With Type 2 Diabetes in New Zealand From 1994 to 2018

Abstract: IMPORTANCE People with type 2 diabetes have greater risk for some site-specific cancers, and risks of cancers differ among racial and ethnic groups in the general population of Aotearoa New Zealand.

Cited by 7 publications

References 27 publications

Long‐term impact of type 2 diabetes onset on dementia incidence rate among New Zealanders with impaired glucose tolerance: A tapered‐matched landmark analysis over 25 years

Long‐term impact of type 2 diabetes onset on dementia incidence rate among New Zealanders with impaired glucose tolerance: A tapered‐matched landmark analysis over 25 years

Association Between Onset of Type 2 Diabetes and Risk of Atrial Fibrillation in New Zealanders With Impaired Glucose Tolerance Over 25 Years

Equity of Cancer and Diabetes Co-Occurrence: A National Study With 44 Million Person-Years of Follow-Up

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