Type 2 diabetes may increase cancer mortality risk in Asians
medwireNews: Analysis of data from more than 750,000 individuals shows that type 2 diabetes is associated with a 26% increased risk for death from any cancer in Asian populations.
The increased risk was even greater for many site-specific cancers including of the endometrium, liver, thyroid, and kidney, report Yu Chen (New York University School of Medicine, USA) and colleagues in Diabetologia.
They say: “The findings indicate a potential need for appropriate cancer screening among individuals with diabetes and a greater emphasis on lifestyle modifications related to cancer mortality not only in Western populations but also in Asians.”
The pooled analysis included 19 prospective population-based cohorts from the Asia Cohort Consortium, comprising data from 658,611 East Asians and 112,686 South Asians from China, Taiwan, Singapore, South Korea, Japan, India, and Bangladesh.
The prevalence of type 2 diabetes among the cohorts ranged from 0.1% to 9.0%, just over half of the participants (50.8%) were men, and the mean age at baseline was 53.9 years.
During a mean follow-up period of 12.7 years, 36,667 cancer deaths were recorded in East Asians and 676 were recorded in South Asians.
Overall, having type 2 diabetes at baseline was associated with a significant 26% increased risk for death from any cancer compared with not having diabetes.
The strongest association was observed for endometrial cancer, at a hazard ratio (HR) of 2.73, followed by cancers of the liver (HR 2.05), thyroid (HR 1.99), kidney (HR 1.84), breast (HR 1.72), ovary (HR 1.60), pancreas (HR 1.53), colorectum (HR 1.41), bile duct (HR 1.41), prostate (HR 1.41), and gallbladder (HR 1.33), as well as lymphoma (HR 1.39).
By contrast, there was no association between baseline diabetes status and the risk of death from leukemia and cancers of the bladder, cervix, esophagus, stomach, and lung.
Chen et al note that “[t]he positive association between diabetes and any cancer was similar in East and South Asians, although the estimate in South Asians did not reach statistical significance, possibly owing to the small number of deaths in participants with diabetes.”
They also point out that their findings were consistent with those of two large studies on digestive and breast cancers in Western countries, suggesting that “the influence of diabetes on the risk of death from overall cancer, digestive cancers and breast cancer is largely similar in Asians and in developed Western countries.”
The researchers conclude: “[G]iven the magnitude of the associations and the consistent data across studies and different populations, diabetes control should be considered in cancer prevention for these cancers in Asians, especially for liver cancer, which has a high incidence in Asians.”
By Laura Cowen
medwireNews is an independent medical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2017