Cancer Causes & Control

, Volume 23, Issue 6, pp 967–981

Diabetes and cancer I: risk, survival, and implications for screening

Authors

    • Department of Hematology/OncologyMarshfield Clinic Weston Center
    • Marshfield Clinic Research Foundation
    • School of Population HealthUniversity of Queensland
  • Jessica M. Engel
    • Department of Hematology/OncologyMarshfield Clinic Cancer Care
  • Ingrid Glurich
    • Marshfield Clinic Research Foundation
  • Rachel V. Stankowski
    • Marshfield Clinic Research Foundation
  • Gail M. Williams
    • School of Population HealthUniversity of Queensland
  • Suhail A. Doi
    • School of Population HealthUniversity of Queensland
Original paper

DOI: 10.1007/s10552-012-9972-3

Cite this article as:
Onitilo, A.A., Engel, J.M., Glurich, I. et al. Cancer Causes Control (2012) 23: 967. doi:10.1007/s10552-012-9972-3

Abstract

Type 2 diabetes mellitus (DM) and cancer are common diseases that are frequently diagnosed in the same individual. An association between the two conditions has long been postulated. Here, we review the epidemiological evidence for increased risk of cancer, decreased cancer survival, and decreased rates of cancer screening in diabetic patients. The risk for several cancers, including cancers of the pancreas, liver, colorectum, breast, urinary tract, and endometrium, is increased in patients with DM. In a pooled risk analysis weighting published meta-analytic relative risk (RR) for individual cancer by differences in their incidence rates, we found a population RR of 0.97 (95 % CI, 0.75–1.25) in men and 1.29 (95 % CI, 1.16–1.44) in women. All meta-analyses showed an increased relative risk for cancer in diabetic men, except studies of prostate cancer, in which a protective effect was observed. The relationship between diabetes and cancer appears to be complex, and at present, a clear temporal relationship between the two conditions cannot be defined. DM also impacts negatively on cancer-related survival outcomes and cancer screening rates. The overwhelming evidence for lower cancer screening rates, increased incidence of certain cancers, and poorer prognosis after cancer diagnosis in diabetic patients dictates a need for improved cancer care in diabetic individuals through improved screening measures, development of risk assessment tools, and consideration of cancer prevention strategies in diabetic patients. Part two of this review focuses on the biological and pharmacological mechanisms that may account for the association between DM and cancer.

Keywords

DiabetesCancerReviewMeta-analysis

Copyright information

© Springer Science+Business Media B.V. 2012