Abstract
Objective
Inconsistent findings from observational studies have prolonged the controversy over the effects of history of diabetes mellitus (DM) on the risk of esophageal cancer (EC). We conducted a meta-analysis of epidemiologic studies to evaluate the association of a history of DM with the risk of EC.
Methods
We identified studies by a literature search of MEDLINE (from 1 January 1966) and EMBASE (from 1 January 1974), through 28 Feburary 2011, and by searching the reference lists of pertinent articles. Summary relative risks (SRRs) with 95% confidence intervals (CIs) were calculated with a random-effects model. All statistical tests were two-sided.
Results
A total of 17 studies (6 case–control studies and 11 cohort studies) fulfilled the inclusion and exclusion criteria. Compared with non-diabetic individuals, diabetic individuals had a modestly increased risk of EC (SRRs 1.30, 95% CI: 1.12–1.50), with significant heterogeneity among studies (p = 0.042). In stratified analysis, the SRRs of EC were 1.28 (1.10–1.49) for diabetic men and 1.07 (95% CI, 0.71–1.62) for diabetic women, respectively. In addition, DM was associated with an increased risk of esophageal adenocarcinoma (SRR 2.12, 95% CI 1.01–4.46). There was no significant publication bias (p = 0.127 for Begg’s adjusted rank correlation test and p = 0.629 for Egger’s regression test).
Conclusion
These findings support the hypothesis that men with diabetes may have a modestly increased risk of EC, while diabetic women were not the case.
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Abbreviations
- DM:
-
Diabetes mellitus
- EC:
-
Esophageal cancer
- ESCC:
-
Esophageal squamous cell carcinoma
- EAC:
-
Esophageal adenocarcinoma
- AORs:
-
Adjusted odds ratios
- SRRs:
-
Summary relative risks
- CI:
-
Confidence intervals
- IGFs:
-
Insulin-like growth factors
- SIR/SMR:
-
Standardized incidence/mortality ratio
- HR:
-
Hazard ratio
- BMI:
-
Body mass index
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Wen Huang and Hongbo Ren contributed equally to this work.
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Huang, W., Ren, H., Ben, Q. et al. Risk of esophageal cancer in diabetes mellitus: a meta-analysis of observational studies. Cancer Causes Control 23, 263–272 (2012). https://doi.org/10.1007/s10552-011-9874-9
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DOI: https://doi.org/10.1007/s10552-011-9874-9