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Diabetes increases cancer mortality risk in Asian adults
Asian adults with diabetes have a 26% increased risk for dying from any cancer compared with those without diabetes, with a greater risk observed for certain site-specific cancers, according to a pooled analysis of 19 prospective Asian cohorts.
“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,” Yu Chen, PhD, MPH, associate professor of epidemiology, departments of population health and environmental medicine, New York University School of Medicine, told Endocrine Today. “The findings indicate a potential need for appropriate cancer screenings among individuals with diabetes, and a greater emphasis on lifestyle modifications to prevent diabetes and reduce cancer mortality, not only in Western populations, but also in Asians.”
Chen and colleagues analyzed data from 19 prospective, population-based cohorts included in the Asia Cohort Consortium, including data from 658,611 East Asians and 112,686 South Asians (mean age, 54 years; 50.8% men; mean follow-up time, 12.7 years). Researchers used HRs to compare individuals with diabetes at baseline with those without diabetes for the risk for death from any cancer and from site-specific cancers, including cancers of the esophagus, stomach, colorectum, colon, rectum, liver, bile duct, pancreas, lung, breast, endometrium, cervix, ovary, prostate, bladder, kidney and thyroid, as well as lymphoma and leukemia. Cancer death was determined from underlying causes of death recorded on death certificates or death records.
Overall, researchers found baseline diabetes status was associated with a higher risk for death from any cancer (HR = 1.26; 95% CI, 1.21-1.31). Adults with diabetes saw the greatest risk for death from cancers of the liver (HR = 2.05; 95% CI, 1.77-2.38), thyroid (HR = 1.99; 95% CI, 1.03-3.86) and kidney (HR = 1.84; 95% CI, 1.28-2.64); women with diabetes saw an increased risk for death from cancer of the endometrium (HR = 2.73; 95% CI, 1.53-4.85). Risk persisted after adjustment that excluded the first 3 years of follow-up, according to the researchers.
They also found a greater risk for death from lymphoma, esophageal cancer and stomach cancer in women with diabetes vs. men with diabetes, observing evidence of effect modification by sex for lymphoma (P for interaction < .01) and stomach cancer (P for interaction = .02). Adults with diabetes aged 60 years or younger at baseline also saw a greater risk for death from any cancer vs. those with diabetes aged at least 60 years (P for interaction < .01).
“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 researchers wrote. “We also found an increased risk associated with diabetes from other cancers, which requires further confirmation.” – by Regina Schaffer
Disclosure: The National Cancer Institute at the NIH and the Fred Hutchinson Cancer Research Center supported this study. The researchers support no relevant financial disclosures.