, Volume 2, Issue 5, pp 307-314

Cancer risk in patients with diabetes mellitus

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Cancer incidence was ascertained in a population-based cohort of 51,008 patients in Uppsala, Sweden, who were given a discharge diagnosis of diabetes mellitus during 1965–83. Complete follow-up through 1984 with exclusion of the first year of observation showed that the observed number of cancers in females (1,294) was eight percent higher than expected (relative risk [RR]=1.1, 95 percent confidence interval =11.0–1.1), whereas in males the observed number (1,123) was close to the expected (RR=1.0, 0.9–1.1). Significantly increased risks of pancreatic (RR=1.4, 1.2–1.7), primary liver (RR=1.5, 1.2–1.7), and endometrial (RR=1.5, 1.2–1.8) cancers and a lower than expected number of prostatic cancers (RR=0.7, 0.7–09) were found in this cohort of diabetic patients. The excess risk of pancreatic cancer was similar in females and males and evident both during one through four years (RR=1.7, 1.4–2.1) and five through nine years (RR=1.3, 0.9−1.7) of follow-up, but not thereafter. A similar pattern was found for primary liver cancer, but the RRs were generally higher in males than in females.

Drs Adami and Ekbom are with the Cancer Epidemiology Unit, University Hospital, Uppsala, Sweden; Dr Ekbom is also in the Department of Surgery. Drs McLaughlin and Silverman are with the Biostatistics Branch, National Cancer Institute, Bethesda, Maryland, USA. Dr Berne is in the Department of Internal Medicine, University Hospital, Uppsala, Sweden. Mr Hacker is with Information Management Services, Silver Spring, Maryland, USA. Dr Persson is in the Department of Obstetrics and Gynaecology, University Hospital, Uppsala, Sweden. Address correspondence to Dr Adami, Cancer Epidemiology Unit, University Hospital, S-751 85 Uppsala, Sweden. This research was supported by grants from the Swedish Cancer Society.