Diabetologia

pp 1–11

Association between type 2 diabetes and risk of cancer mortality: a pooled analysis of over 771,000 individuals in the Asia Cohort Consortium

  • Yu Chen
  • Fen Wu
  • Eiko Saito
  • Yingsong Lin
  • Minkyo Song
  • Hung N. Luu
  • Prakash C. Gupta
  • Norie Sawada
  • Akiko Tamakoshi
  • Xiao-Ou Shu
  • Woon-Puay Koh
  • Yong-Bing Xiang
  • Yasutake Tomata
  • Kemmyo Sugiyama
  • Sue K. Park
  • Keitaro Matsuo
  • Chisato Nagata
  • Yumi Sugawara
  • You-Lin Qiao
  • San-Lin You
  • Renwei Wang
  • Myung-Hee Shin
  • Wen-Harn Pan
  • Mangesh S. Pednekar
  • Shoichiro Tsugane
  • Hui Cai
  • Jian-Min Yuan
  • Yu-Tang Gao
  • Ichiro Tsuji
  • Seiki Kanemura
  • Hidemi Ito
  • Keiko Wada
  • Yoon-Ok Ahn
  • Keun-Young Yoo
  • Habibul Ahsan
  • Kee Seng Chia
  • Paolo Boffetta
  • Wei Zheng
  • Manami Inoue
  • Daehee Kang
  • John D. Potter
Article

DOI: 10.1007/s00125-017-4229-z

Cite this article as:
Chen, Y., Wu, F., Saito, E. et al. Diabetologia (2017). doi:10.1007/s00125-017-4229-z

Abstract

Aims/hypothesis

The aims of the study were to evaluate the association between type 2 diabetes and the risk of death from any cancer and specific cancers in East and South Asians.

Methods

Pooled analyses were conducted of 19 prospective population-based cohorts included in the Asia Cohort Consortium, comprising data from 658,611 East Asians and 112,686 South Asians. HRs were used to compare individuals with diabetes at baseline with those without diabetes for the risk of death from any cancer and from site-specific cancers, including cancers of the oesophagus, stomach, colorectum, colon, rectum, liver, bile duct, pancreas, lung, breast, endometrium, cervix, ovary, prostate, bladder, kidney and thyroid, as well as lymphoma and leukaemia.

Results

During a mean follow-up of 12.7 years, 37,343 cancer deaths (36,667 in East Asians and 676 in South Asians) were identified. Baseline diabetes status was statistically significantly associated with an increased risk of death from any cancer (HR 1.26; 95% CI 1.21, 1.31). Significant positive associations with diabetes were observed for cancers of the colorectum (HR 1.41; 95% CI 1.26, 1.57), liver (HR 2.05; 95% CI 1.77, 2.38), bile duct (HR 1.41; 95% CI 1.04, 1.92), gallbladder (HR 1.33; 95% CI 1.10, 1.61), pancreas (HR 1.53; 95% CI 1.32, 1.77), breast (HR 1.72; 95% CI 1.34, 2.19), endometrium (HR 2.73; 95% CI 1.53, 4.85), ovary (HR 1.60; 95% CI 1.06, 2.42), prostate (HR 1.41; 95% CI 1.09, 1.82), kidney (HR 1.84; 95% CI 1.28, 2.64) and thyroid (HR 1.99; 95% CI 1.03, 3.86), as well as lymphoma (HR 1.39; 95% CI 1.04, 1.86). Diabetes was not statistically significantly associated with the risk of death from leukaemia and cancers of the bladder, cervix, oesophagus, stomach and lung.

Conclusions/interpretation

Diabetes was associated with a 26% increased risk of death from any cancer in Asians. The pattern of associations with specific cancers suggests the need for better control (prevention, detection, management) of the growing epidemic of diabetes (as well as obesity), in order to reduce cancer mortality.

Keywords

Asia Cohort Consortium Asians Cancer mortality Meta-analysis Type 2 diabetes 

Abbreviations

ACC

Asia ohort Consortium

CPS II

Cancer Prevention Study II

CVD

Cardiovascular disease

ERFC

Emerging risk factors collaboration

Supplementary material

125_2017_4229_MOESM1_ESM.pdf (151 kb)
ESM 1(PDF 151 kb)

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Yu Chen
    • 1
    • 2
  • Fen Wu
    • 1
    • 2
  • Eiko Saito
    • 3
    • 4
  • Yingsong Lin
    • 5
  • Minkyo Song
    • 6
  • Hung N. Luu
    • 7
    • 8
  • Prakash C. Gupta
    • 9
  • Norie Sawada
    • 4
  • Akiko Tamakoshi
    • 10
  • Xiao-Ou Shu
    • 7
  • Woon-Puay Koh
    • 11
    • 12
  • Yong-Bing Xiang
    • 13
  • Yasutake Tomata
    • 14
  • Kemmyo Sugiyama
    • 14
  • Sue K. Park
    • 15
  • Keitaro Matsuo
    • 16
    • 17
  • Chisato Nagata
    • 18
  • Yumi Sugawara
    • 14
  • You-Lin Qiao
    • 19
  • San-Lin You
    • 20
    • 21
  • Renwei Wang
    • 22
  • Myung-Hee Shin
    • 23
  • Wen-Harn Pan
    • 24
  • Mangesh S. Pednekar
    • 9
  • Shoichiro Tsugane
    • 4
  • Hui Cai
    • 7
  • Jian-Min Yuan
    • 25
    • 26
  • Yu-Tang Gao
    • 13
  • Ichiro Tsuji
    • 14
  • Seiki Kanemura
    • 14
  • Hidemi Ito
    • 17
    • 27
  • Keiko Wada
    • 18
  • Yoon-Ok Ahn
    • 15
  • Keun-Young Yoo
    • 28
  • Habibul Ahsan
    • 29
  • Kee Seng Chia
    • 12
  • Paolo Boffetta
    • 30
  • Wei Zheng
    • 7
  • Manami Inoue
    • 3
    • 4
  • Daehee Kang
    • 15
    • 31
    • 32
  • John D. Potter
    • 33
    • 34
    • 35
  1. 1.Department of Population HealthNew York University School of MedicineNew YorkUSA
  2. 2.Department of Environmental MedicineNew York University School of MedicineTuxedo ParkUSA
  3. 3.AXA Department of Health and Human Security, Graduate School of MedicineUniversity of TokyoTokyoJapan
  4. 4.Epidemiology and Prevention Group, Center for Public Health SciencesNational Cancer CenterTokyoJapan
  5. 5.Department of Public HealthAichi Medical University School of MedicineNagakuteJapan
  6. 6.Division of Cancer Epidemiology and Genetics, National Cancer InstituteNational Institutes of HealthBethesdaUSA
  7. 7.Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer CenterVanderbilt University School of MedicineNashvilleUSA
  8. 8.Department of Epidemiology and Biostatistics, College of Public HealthUniversity of South FloridaTampaUSA
  9. 9.Healis Sekhsaria Institute for Public HealthNavi MumbaiIndia
  10. 10.Graduate School of MedicineHokkaido UniversitySapporoJapan
  11. 11.Duke-NUS Medical School SingaporeSingaporeRepublic of Singapore
  12. 12.Saw Swee Hock School of Public HealthNational University of SingaporeSingaporeRepublic of Singapore
  13. 13.Shanghai Cancer Institute, Shanghai Jiaotong UniversityShanghaiPeople’s Republic of China
  14. 14.Tohoku University Graduate School of MedicineMiyagi PrefectureJapan
  15. 15.Department of Preventive MedicineSeoul National University College of MedicineSeoulSouth Korea
  16. 16.Division of Molecular MedicineAichi Cancer Center Research InstituteNagoyaJapan
  17. 17.Department of EpidemiologyNagoya University Graduate School of MedicineNagoyaJapan
  18. 18.Graduate School of MedicineGifu UniversityGifuJapan
  19. 19.Cancer Foundation of ChinaBeijingPeople’s Republic of China
  20. 20.School of MedicineFu-Jen Catholic UniversityTaipeiTaiwan
  21. 21.Big Data Research CentreFu-Jen Catholic UniversityTaipeiTaiwan
  22. 22.University of Pittsburgh Cancer InstitutePittsburghUSA
  23. 23.Department of Social and Preventive MedicineSungkyunkwan University School of MedicineSeoulSouth Korea
  24. 24.Institute of Biomedical Sciences, Academia SinicaTaipeiTaiwan
  25. 25.Department of EpidemiologyUniversity of Pittsburgh Graduate School of Public HealthPittsburghUSA
  26. 26.Division of Cancer Control and Population ScienceUniversity of Pittsburgh Cancer InstitutePittsburghUSA
  27. 27.Division of Epidemiology and PreventionAichi Cancer Center Research InstituteNagoyaJapan
  28. 28.Armed Forces Capital HospitalSeoul National University College of MedicineSeoulSouth Korea
  29. 29.Department of Public Health SciencesUniversity of ChicagoChicagoUSA
  30. 30.Icahn School of Medicine at Mount SinaiNew YorkUSA
  31. 31.Department of Biomedical SciencesSeoul National University Graduate SchoolSeoulSouth Korea
  32. 32.Cancer Research InstituteSeoul National UniversitySeoulSouth Korea
  33. 33.Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleUSA
  34. 34.Centre for Public Health ResearchMassey UniversityWellingtonNew Zealand
  35. 35.Department of EpidemiologyUniversity of WashingtonSeattleUSA

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