Risk of cancer in a large cohort of U.S. veterans with diabetes

Atchison, Elizabeth A.; Gridley, Gloria; Carreon, Joseph D.; Leitzmann, Michael F.; McGlynn, Katherine A.

doi:10.1002/ijc.25362

Cited by 215 publications

(295 citation statements)

References 63 publications

(108 reference statements)

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“…In addition, the risk of lung cancer was increased in individuals with diabetes in our study results. However, this association is not consistent in the literature, with studies showing both decreased and increased risks of this type of cancer in individuals with diabetes (5,8). Finally, we did not find a significant association between diabetes and pancreatic cancer, despite a suggested link between the two diseases (8).…”

Section: Most Common Causes Of Death In Diabetescontrasting

confidence: 99%

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Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis

et al. 2016

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OBJECTIVEDiabetes is a common cause of shortened life expectancy. We aimed to assess the association between diabetes and cause-specific death. RESEARCH DESIGN AND METHODSWe used the pooled analysis of individual data from 12 Spanish population cohorts with 10-year follow-up. Participants had no previous history of cardiovascular diseases and were 35-79 years old. Diabetes status was self-reported or defined as glycemia >125 mg/dL at baseline. Vital status and causes of death were ascertained by medical records review and linkage with the official death registry. The hazard ratios and cumulative mortality function were assessed with two approaches, with and without competing risks: proportional subdistribution hazard (PSH) and cause-specific hazard (CSH), respectively. Multivariate analyses were fitted for cardiovascular, cancer, and noncardiovascular noncancer deaths. RESULTSWe included 55,292 individuals (15.6% with diabetes and overall mortality of 9.1%). The adjusted hazard ratios showed that diabetes increased mortality risk: 1) cardiovascular death, CSH = 2.03 (95% CI 1.63-2.52) and PSH = 1.99 (1.60-2.49) in men; and CSH = 2.28 (1.75-2.97) and PSH = 2.23 (1.70-2.91) in women; 2) cancer death, CSH = 1.37 (1.13-1.67) and PSH = 1.35 (1.10-1.65) in men; and CSH = 1.68 (1.29-2.20) and PSH = 1.66 (1.25-2.19) in women; and 3) noncardiovascular noncancer death, CSH = 1.53 (1.23-1.91) and PSH = 1.50 (1.20-1.89) in men; and CSH = 1.89 (1.43-2.48) and PSH = 1.84 (1.39-2.45) in women. In all instances, the cumulative mortality function was significantly higher in individuals with diabetes. CONCLUSIONSDiabetes is associated with premature death from cardiovascular disease, cancer, and noncardiovascular noncancer causes. The use of CSH and PSH provides a comprehensive view of mortality dynamics in a population with diabetes.Diabetes constitutes a worldwide public health problem (1) that affected 382 million people (8.3% of the world's population) in 2013 (2). Recent projections suggest that this prevalence is likely to increase in the next 20 years, affecting 592 million people (10.1%) in 2035. In Spain, diabetes affects 13.8% of individuals older than 18 years and is more prevalent in men than in women (3,4).The average life expectancy of a 50-year-old individual with diabetes is 6 years shorter than it would be without the disease (5). Diabetes not only doubles or

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Section: Most Common Causes Of Death In Diabetescontrasting

confidence: 99%

“…quadruples cardiovascular risk, compared with the general population (6,7), but also leads to an increased risk of cancer, as shown by some cohort studies (5,8).…”

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confidence: 89%

Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis

et al. 2016

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“…In a recent study of over 4 million US veterans with DM, Atchison et al 22 found a 7% reduction in overall cancer risk, and a statistically significant 11% decrease in risk of PCa when compared with those without DM.…”

Section: Discussionmentioning

confidence: 99%

The association of diabetes and positive prostate biopsy in a US veteran population

Moses

Utuama

Goodman

et al. 2011

Prostate Cancer Prostatic Dis

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BACKGROUND:Several studies have shown a protective effect of diabetes mellitus (DM) on incidence of prostate cancer; however, the data are not consistent. Moreover, whether or not DM is associated with a positive result among patients referred for prostate biopsy due to abnormal PSA and/or abnormal digital rectal examination is not clear. METHODS:A retrospective review of 3162 consecutive men who underwent prostate biopsy between January 2000 and July 2009 at the Atlanta Veterans Affairs Medical Center was performed. Men with positive and negative biopsies were compared for various demographic and clinical factors. The data were analyzed using logistic regression models with results expressed as adjusted odds ratios (ORs) with corresponding 95% confidence intervals (CI).RESULTS: DM was associated with increased odds of positive biopsy in the overall cohort (OR 1.26, 95% CI: 1.01-1.55; P ¼ 0.04). Subjects with DM had higher odds of more aggressive disease (Gleason X7) than those without the condition (OR 1.31, 95% CI: 0.98-1.74; P ¼ 0.07). Race had no significant impact on these results. CONCLUSIONS:In this large series of prostate biopsies, diabetes is associated with higher odds of positive biopsy and higher Gleason grade. More studies investigating the role of DM and its associated comorbidities in prostate carcinogenesis are needed.

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“…Some prospective studies reported that DM determined by questionnaire or medical records is positively associated with gastric cancer, [3][4][5][6] but others found a null association. [7][8][9][10][11][12] However, DM can be easily misclassified when based on self-report of disease in questionnaire survey or medical records. To overcome this problem, several studies were directly based on diabetic biomarkers, such as hemoglobin A1c (HbA1c) and blood glucose, but the associations were also inconsistent in these prospective studies.…”

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confidence: 99%

Plasma insulin, C‐peptide and blood glucose and the risk of gastric cancer: The Japan Public Health Center‐based prospective study

Hidaka¹,

Sasazuki

Goto

et al. 2014

Intl Journal of Cancer

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To date, the association between diabetes mellitus (DM) and gastric cancer has been controversial, including the underlying mechanism. We investigated the association between plasma diabetic biomarkers (insulin, C-peptide, and blood glucose) and gastric cancer risk. In addition, homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of b-cell function (HOMA-b) were calculated. A total of 36,745 subjects aged 40-69 years in the Japan Public Health Center-based prospective study (JPHC) who returned the baseline questionnaire and provided blood samples were followed from 1990 to 2004. In the present analysis, 477 cases and 477 matched controls were used. The odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) for developing gastric cancer were calculated using conditional logistic regression models. Plasma insulin was positively associated with increased risk of gastric cancer; compared to tertile 1, ORs were 1.69 (95% CI 5 1.11-2.59) and 2.01 (1.19-3.38) for tertiles 2 and 3, respectively (p for trend 5 0.009). In men, Cpeptide was also positively associated with a significant risk; corresponding ORs were 1.42 (0.85-2.38) and 1.91 (1.03-3.54), respectively (p for trend 5 0.04). These findings were confirmed for blood samples from the fasting group (8 hr after a meal). Higher HOMA-IR was also associated with increased risk, whereas no association was observed for blood glucose. Our findings suggest that Japanese population with higher insulin and C-peptide levels derived from insulin resistance have an elevated risk of gastric cancer.Gastric cancer is the second leading cause of death and the fourth most common cancer in the world. 1 Although Helicobacter pylori (H. pylori) infection is well known as a major risk factor for gastric cancer, only some of the people infected with H. pylori will develop gastric cancer. Therefore, other risk factors might affect the association between H. pylori and gastric cancer occurrence.Diabetes mellitus (DM) is associated with many types of cancer, including colorectal, liver, breast, and pancreatic cancer.2 However, the association between DM and gastric cancer remains to be clarified. Some prospective studies reported that DM determined by questionnaire or medical records is positively associated with gastric cancer, 3-6 but others found a null association.7-12 However, DM can be easily misclassified when based on self-report of disease in questionnaire survey or medical records. To overcome this problem, several studies were directly based on diabetic biomarkers, such as hemoglobin A1c (HbA1c) and blood glucose, but the associations were also inconsistent in these prospective studies. [13][14][15][16]

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Risk of cancer in a large cohort of U.S. veterans with diabetes

Cited by 215 publications

References 63 publications

Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis

Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis

The association of diabetes and positive prostate biopsy in a US veteran population

Plasma insulin, C‐peptide and blood glucose and the risk of gastric cancer: The Japan Public Health Center‐based prospective study

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