Meta-analysis

Diabetologia

, Volume 57, Issue 11, pp 2261-2269

First online:

Prediabetes and the risk of cancer: a meta-analysis

  • Yi HuangAffiliated withClinical Medicine Research Center, The First People’s Hospital of Shunde
  • , Xiaoyan CaiAffiliated withClinical Medicine Research Center, The First People’s Hospital of Shunde
  • , Miaozhen QiuAffiliated withDepartment of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China
  • , Peisong ChenAffiliated withDepartment of Laboratory Medicine, the First Affiliated Hospital of Sun Yat-sen University
  • , Hongfeng TangAffiliated withClinical Medicine Research Center, The First People’s Hospital of Shunde
  • , Yunzhao HuAffiliated withClinical Medicine Research Center, The First People’s Hospital of Shunde Email author 
  • , Yuli HuangAffiliated withClinical Medicine Research Center, The First People’s Hospital of Shunde Email author 

Abstract

Aims/hypothesis

The results from prospective cohort studies of prediabetes (impaired fasting glucose and/or impaired glucose tolerance) and risk of cancer are controversial. We conducted a meta-analysis to evaluate the risk of cancer in association with impaired fasting glucose and impaired glucose tolerance.

Methods

The PubMed, EMBASE and Cochrane Library databases were searched for prospective cohort studies with data on prediabetes and cancer. Two independent reviewers assessed the reports and extracted the data. Prospective studies were included if they reported adjusted RRs with 95% CIs for the association between cancer and prediabetes. Subgroup analyses were conducted according to endpoint, age, sex, ethnicity, duration of follow-up and study characteristics.

Results

Data from 891,426 participants were derived from 16 prospective cohort studies. Prediabetes was associated with an increased risk of cancer overall (RR 1.15; 95% CI 1.06, 1.23). The results were consistent across cancer endpoint, age, duration of follow-up and ethnicity. There was no significant difference for the risk of cancer with different definitions of prediabetes. In a site-specific cancer analysis, prediabetes was significantly associated with increased risks of cancer of the stomach/colorectum, liver, pancreas, breast and endometrium (all p < 0.05), but not associated with cancer of the bronchus/lung, prostate, ovary, kidney or bladder. The risks of site-specific cancer were significantly different (p = 0.01) and were highest for liver, endometrial and stomach/colorectal cancer.

Conclusions/interpretation

Overall, prediabetes was associated with an increased risk of cancer, especially liver, endometrial and stomach/colorectal cancer.

Keywords

Cancer Impaired fasting glucose Impaired glucose tolerance Prediabetes Risk factors