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Click to add/remove this article to your list of 'My Favorites' Diabetes and the Risk of Cancer Death: a Case-Cohort Study in Taiwanese Men

Year: 2008

Abstract Number: 23-LB

Authors: RUBEN HERNAEZ, HSIN-CHIEH YEH, HUI-MING CHUNG, MIN-CHEN LI, FREDERICK L. BRANCATI, Baltimore, MD, Taipei, Taiwan

Institutions: Baltimore, MD

Results: Whereas recent evidence suggests that diabetes mellitus may be a risk factor for the development of cancer, few prospective studies have addressed the impact of diabetes on cancer in Asian populations. We conducted a case-cohort study using longitudinal data from MJ Health Study, a private health screening program based in Taiwan, to determine the risk of cancer death in adults with vs. without diabetes. At baseline in 1996 to 2003, 54,751 men aged 40-80 years completed a detailed health screening, and were followed through 2005 for mortality (mean follow-up, 5.8±2.5 years) by linking with the National Death Registry. We excluded men with cancer at baseline and cancer deaths occurred within the first 2 years of follow-up. Therefore, a total of 951 cancer deaths, including 238 liver, 222 lung, and 80 colorectal cancers, were included for analysis. For comparison, a sub-cohort of 4,000 men (mean age 54±10) was randomly selected from the original population. The prevalence of diabetes (defined by self-reported diabetes, use of anti-diabetes medication, or fasting plasma glucose ≥126 mg/dl) was 44% and 24% in the case and in the sub-cohort, respectively. In the multivariate analysis using Cox proportional hazards model with variance correction for the case-cohort design, diabetes was associated with significantly elevated risk for overall cancer mortality [Hazard Ratio 1.21, 95% CI, 1.04 - 1.40], after adjustments for age, body-mass index, smoking, alcohol intake, and education. In particular, adults with diabetes were 2.6 times more likely to die from bladder cancer [HR, 2.63, 95%CI, 1.04 - 6.67], and 55% more likely to die from liver cancer [HR, 1.55, 95%CI, 1.13 - 2.14, with further adjustment for the hepatitis B status] compared to their non-diabetic counterparts (see Figure). Increased but non-significant risks of cancer death were also observed for other sites, but not for lung or hematologic malignancies. Our study suggests that diabetes is a risk factor for cancer mortality in this Asian population. Whether improvements in diabetes prevention and care for people with cancer could reduce mortality deserves further investigation.[figure1]

Category: Epidemiology

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