Fred Hutchinson Cancer Research Center, Mailstop: M4-C308, 1100 Fairview Ave N., Seattle, WA 98109, USA.
Cancer Epidemiol Biomarkers Prev. 2012 Feb;21(2):294-304. doi: 10.1158/1055-9965.EPI-11-0590. Epub 2011 Dec 5.
A history of diabetes is associated with an increased risk of several types of cancers. Whether diabetes is a risk factor for head and neck cancer (HNC) has received little attention.
We pooled data from 12 case-control studies including 6,448 cases and 13,747 controls, and estimated OR and 95% CI for the associations between diabetes and HNC, adjusted for age, education level, sex, race/ethnicity, study center, cigarette smoking, alcohol use, and body mass index.
We observed a weak association between diabetes and the incidence of HNC overall (OR, 1.09; 95% CI: 0.95-1.24). However, we observed a modest association among never smokers (OR, 1.59; 95% CI: 1.22-2.07), and no association among ever smokers (OR, 0.96; 95% CI: 0.83-1.11); likelihood ratio test for interaction P = 0.001.
A history of diabetes was weakly associated with HNC overall, but we observed evidence of effect modification by smoking status, with a positive association among those who never smoked cigarettes.
This study suggests that glucose metabolism abnormalities may be a HNC risk factor in subgroups of the population. Prospective studies incorporating biomarkers are needed to improve our understanding of the relationship between diabetes and HNC risk, possibly providing new strategies in the prevention of HNC.
糖尿病病史与多种癌症的风险增加相关。糖尿病是否是头颈部癌症（HNC）的危险因素尚未得到充分关注。
我们汇总了 12 项病例对照研究的数据，共纳入 6448 例病例和 13747 例对照，调整了年龄、教育水平、性别、种族/民族、研究中心、吸烟、饮酒和体重指数等因素后，估计了糖尿病与 HNC 之间的比值比（OR）和 95%置信区间（CI）。
我们观察到糖尿病与 HNC 总体发病率之间存在微弱关联（OR，1.09；95%CI：0.95-1.24）。然而，我们在从不吸烟者中观察到了适度的关联（OR，1.59；95%CI：1.22-2.07），而在曾吸烟者中则没有关联（OR，0.96；95%CI：0.83-1.11）；交互作用的似然比检验 P = 0.001。
糖尿病病史与 HNC 总体呈弱相关，但我们观察到吸烟状态存在效应修饰的证据，从不吸烟的人群中存在正相关。
本研究表明，葡萄糖代谢异常可能是人群中某些亚组的 HNC 危险因素。需要进行包含生物标志物的前瞻性研究，以提高我们对糖尿病与 HNC 风险之间关系的理解，可能为 HNC 的预防提供新策略。
