Association between type 2 diabetes and risk of cancer mortality: a pooled analysis of over 771,000 individuals in the Asia Cohort Consortium.
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Chen Yu, Wu Fen, Saito Eiko, Lin Yingsong, Song Minkyo, Luu Hung N, Gupta Prakash C, Sawada Norie, Tamakoshi Akiko, Shu Xiao-Ou, Koh Woon-Puay, Xiang Yong-Bing, Tomata Yasutake, Sugiyama Kemmyo, Park Sue K, Matsuo Keitaro, Nagata Chisato, Sugawara Yumi, Qiao You-Lin, You San-Lin, Wang Renwei, Shin Myung-Hee, Pan Wen-Harn, Pednekar Mangesh S, Tsugane Shoichiro, Cai Hui, Yuan Jian-Min, Gao Yu-Tang, Tsuji Ichiro, Kanemura Seiki, Ito Hidemi, Wada Keiko, Ahn Yoon-Ok, Yoo Keun-Young, Ahsan Habibul, Chia Kee Seng, Boffetta Paolo, Zheng Wei, Inoue Manami, Kang Daehee, Potter John D
Аннотация
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.