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Diabetologia. 2017 Jun;60(6):1022-1032. doi: 10.1007/s00125-017-4229-z. Epub 2017 Mar 7.

Association between type 2 diabetes and risk of cancer mortality: a pooled analysis of over 771,000 individuals in the Asia Cohort Consortium.

Author information

1
Department of Population Health, New York University School of Medicine, 650 First Avenue, Room 510, New York, NY, 10016, USA. yu.chen@nyumc.org.
2
Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, NY, 10987, USA. yu.chen@nyumc.org.
3
Department of Population Health, New York University School of Medicine, 650 First Avenue, Room 510, New York, NY, 10016, USA.
4
Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, NY, 10987, USA.
5
AXA Department of Health and Human Security, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
6
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
7
Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Japan.
8
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
9
Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
10
Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA.
11
Healis Sekhsaria Institute for Public Health, Navi Mumbai, India.
12
Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
13
Duke-NUS Medical School Singapore, Singapore, Republic of Singapore.
14
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore.
15
Shanghai Cancer Institute, Shanghai Jiaotong University, Shanghai, People's Republic of China.
16
Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.
17
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea.
18
Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan.
19
Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
20
Graduate School of Medicine, Gifu University, Gifu, Japan.
21
Cancer Foundation of China, Beijing, People's Republic of China.
22
School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan.
23
Big Data Research Centre, Fu-Jen Catholic University, Taipei, Taiwan.
24
University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.
25
Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea.
26
Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
27
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
28
Division of Cancer Control and Population Science, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.
29
Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
30
Armed Forces Capital Hospital, Seoul National University College of Medicine, Seoul, South Korea.
31
Department of Public Health Sciences, University of Chicago, Chicago, IL, USA.
32
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
33
Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea.
34
Cancer Research Institute, Seoul National University, Seoul, South Korea.
35
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
36
Centre for Public Health Research, Massey University, Wellington, New Zealand.
37
Department of Epidemiology, University of Washington, Seattle, WA, USA.

Abstract

AIMS/HYPOTHESIS:

The aims of the study were to evaluate the association between type 2 diabetes and the risk of death from any cancer and specific cancers in East and South Asians.

METHODS:

Pooled analyses were conducted of 19 prospective population-based cohorts included in the Asia Cohort Consortium, comprising data from 658,611 East Asians and 112,686 South Asians. HRs were used to compare individuals with diabetes at baseline with those without diabetes for the risk of death from any cancer and from site-specific cancers, including cancers of the oesophagus, stomach, colorectum, colon, rectum, liver, bile duct, pancreas, lung, breast, endometrium, cervix, ovary, prostate, bladder, kidney and thyroid, as well as lymphoma and leukaemia.

RESULTS:

During a mean follow-up of 12.7 years, 37,343 cancer deaths (36,667 in East Asians and 676 in South Asians) were identified. Baseline diabetes status was statistically significantly associated with an increased risk of death from any cancer (HR 1.26; 95% CI 1.21, 1.31). Significant positive associations with diabetes were observed for cancers of the colorectum (HR 1.41; 95% CI 1.26, 1.57), liver (HR 2.05; 95% CI 1.77, 2.38), bile duct (HR 1.41; 95% CI 1.04, 1.92), gallbladder (HR 1.33; 95% CI 1.10, 1.61), pancreas (HR 1.53; 95% CI 1.32, 1.77), breast (HR 1.72; 95% CI 1.34, 2.19), endometrium (HR 2.73; 95% CI 1.53, 4.85), ovary (HR 1.60; 95% CI 1.06, 2.42), prostate (HR 1.41; 95% CI 1.09, 1.82), kidney (HR 1.84; 95% CI 1.28, 2.64) and thyroid (HR 1.99; 95% CI 1.03, 3.86), as well as lymphoma (HR 1.39; 95% CI 1.04, 1.86). Diabetes was not statistically significantly associated with the risk of death from leukaemia and cancers of the bladder, cervix, oesophagus, stomach and lung.

CONCLUSIONS/INTERPRETATION:

Diabetes was associated with a 26% increased risk of death from any cancer in Asians. The pattern of associations with specific cancers suggests the need for better control (prevention, detection, management) of the growing epidemic of diabetes (as well as obesity), in order to reduce cancer mortality.

KEYWORDS:

Asia Cohort Consortium; Asians; Cancer mortality; Meta-analysis; Type 2 diabetes

PMID:
28265721
PMCID:
PMC5632944
DOI:
10.1007/s00125-017-4229-z
[Indexed for MEDLINE]
Free PMC Article

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