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

• Published in: Diabetologia Vol. 60; no. 6; pp. 1022 - 1032
• Main Authors: 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.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2017; Springer Nature B.V
• Subjects: Aged; Asia; Bile ducts; Cancer; Cervix; Colon; Consortia; Death; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - mortality; Diabetes Mellitus, Type 2 - physiopathology; Endometrium; Esophagus; Exercise; Female; Gallbladder; Health risk assessment; Human Physiology; Humans; Hypertension - mortality; Hypertension - physiopathology; Internal Medicine; Kidneys; Leukemia; Liver; Lungs; Lymphoma; Male; Medicine; Medicine & Public Health; Meta-analysis; Metabolic Diseases; Middle Aged; Mortality; Neoplasms - mortality; Neoplasms - physiopathology; Pancreas; Prostate; Randomized Controlled Trials as Topic; Rectum; Stomach; Surveys and Questionnaires; Thyroid; Thyroid gland; Urinary bladder; Type 2 diabetes; Cancer mortality; Asia Cohort Consortium; Asians; Meta-analysis
• ISSN: 0012-186X; 1432-0428; 1432-0428
• DOI: 10.1007/s00125-017-4229-z

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.