Increased cancer incidence risk in type 2 diabetes mellitus: results from a cohort study in Tyrol/Austria

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• 作者：Willi Oberaigner (7)
  Christoph Ebenbichler (8)
  Karin Oberaigner (7)
  Martin Juchum (9)
  Hans Robert Sch枚nherr (10)
  Monika Lechleitner (11)
  
  7. Department of Clinical Epidemiology of the Tyrolean State Hospitals Ltd ; Cancer Registry of Tyrol ; TILAK GmbH ; Anichstrasse 35 ; Innsbruck ; Austria
  8. Department of Internal Medicine I ; Medical University Innsbruck ; Anichstrasse 35 ; 6020 ; Innsbruck ; Austria
  9. Department of Internal Medicine ; University Teaching Hospital Hall ; Hall ; Austria
  10. Department of Internal Medicine ; Saint Vincent Hospital Zams ; Zams ; Austria
  11. Department of Internal and Geriatric Medicine ; Hochzirl Hospital ; Zirl ; Austria
  
• 关键词：Cancer ; Type 2 diabetes ; Cohort study ; Registry
• 刊名：BMC Public Health
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：330 KB
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  33. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2458/14/1058/prepub
  
• 刊物主题：Public Health; Medicine/Public Health, general; Epidemiology; Environmental Health; Biostatistics; Vaccine;
• 出版者：BioMed Central
• ISSN：1471-2458

文摘

Background Recent meta-analyses revealed an association between type 2 diabetes mellitus (T2DM) and cancer. The strongest relationship was demonstrated for liver and pancreatic cancer, followed by endometrial cancer. We aimed at assessing the association between T2DM and cancer specifically for Tyrolean patients. Methods We investigated cancer incidence in Tyrolean subjects with T2DM by linking the data from the Diabetes and the Cancer Registries. 5709 T2DM patients were included and the sex- and age-adjusted standardized incidence ratio (SIR) was calculated, cancer incidence in the Tyrolean population serving as the standard. Endpoints were the time at which cancer was diagnosed, death or end of the observation period (31 December 2010). Results Site-specific analyses revealed statistically significantly elevated SIRs for cancer of the pancreas (1.78, 95% CI 1.02, 2.89) and corpus (1.79, 95% CI 1.15, 2.66) for women, and cancer of the liver (2.71, 95% CI 1.65, 4.18) and pancreas (1.87, 95% 1.11, 2.96) for men. Sub-analyses performed according to the time of diabetes diagnosis revealed that SIR was highest in the first year after diabetes diagnosis, but SIR was demonstrated to be elevated in women for cancer of the liver (SIR 3.37, 95% CI 1.24, 7.34) and corpus (SIR 1.94, 95% CI 1.09, 3.20) and in men for liver (SIR 2.71, 95% CI 1.40, 4.74) in the period more than five years after diabetes diagnosis. In addition, increased risk at borderline statistical significance was observed in females for liver cancer (SIR 2.40, 95% CI 0.96, 4.94) and cervical cancer (SIR 1.81, 95% CI 0.87, 3.32) and in males for kidney cancer (SIR 1.65, 95% CI 0.99, 2.57). Conclusion This study revealed a higher risk for cancer at certain sites in Tyrolean patients with T2DM. However, it is important to interpret the results with great caution due to inherent methodological problems. Optimized care programs for patients with T2DM should be integrated into the recommended procedures for cancer screening.