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Diabetes increased risk for breast, colorectal cancers
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Patients with diabetes were at increased risk for breast and colorectal cancer incidence and mortality, according to results of a pooled meta-analysis presented at the European Cancer Congress.
“Cancer patients who are obese and diabetic are an already more vulnerable group of individuals when it comes to surgery, as they have an increased risk of developing complications both during and after surgery,” lead study author Kirstin De Bruijn, MD, a PhD student in the surgery department at Erasmus University Medical Center in Rotterdam, The Netherlands, said in a press release. “If more obese and diabetic patients have to have an operation because of cancer, healthcare costs will increase.”
De Bruijn and colleagues reviewed data from 20 studies that included 1.9 million patients with diabetes. Researchers conducted sensitivity and subgroup analyses to account for variations in cofounders, modes of diabetes diagnosis and follow-up times.
Overall, researchers calculated increased risk for breast cancer incidence (HR=1.23; 95% CI, 1.12-1.34) and colorectal cancer incidence (HR=1.26; 95% CI, 1.14-1.40).
They also calculated increased risks for breast cancer-specific mortality (HR=1.38; 95% CI, 1.20-1.58) and colorectal cancer-specific mortality (HR=1.30; 95% CI, 1.15-1.47).
The results were consistent across all studies, and researchers observed no publication bias.
“Worldwide, the numbers of obese and subsequently diabetic patients are still increasing, and it is a cause for concern that these individuals are at a higher risk of developing cancer and dying from it,” De Bruijn said. “We want to make more people aware of this problem, and we hope that prevention campaigns regarding obese and diabetic patients will focus on highlighting this increased risk.”
For more information:
De Bruijn K. Abstract #1402. Presented at: The European Cancer Congress 2013. Sept. 27 – Oct. 2, 2013; Amsterdam.
Disclosure: The researchers report no relevant financial disclosures.Perspective
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Cornelis van de Velde, MD, PhD
With the increase in incidence of both diabetes and breast cancer, this is an important update of the meta-analyses on this subject and an interesting addition to the literature as this study excluded other causes of death. As the results are consistent with earlier meta-analyses, the substantial increased risk for breast cancer should be part of prevention campaigns. For further research, it would be important to study how other competing risk factors might affect survival, as elderly cancer patients with diabetes are usually diagnosed with other conditions as well. Additionally, the potential role of metformin in relation to improved survival and cancer recurrence needs to be studied.
Perspective
Back to TopHans-Joerg Senn, MD, PhD
The message from the Erasmus Medical Center is disturbing and highly important for the medical community, as well as for the public and politicians. It highlights once more the importance of the negative interactions between lifestyle, metabolism, overweight and certain frequent types of cancers, such as here between diabetes, obesity and breast cancer as well as colon cancer. It is time for increased and more effective information and prevention campaigns, especially in the economically developed world, where caloric abundance is prevalent.
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