Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan.
Clin Oral Investig. 2013 Jun;17(5):1357-64. doi: 10.1007/s00784-012-0820-3. Epub 2012 Aug 16.
The association between diabetes and oral cancer is rarely studied. We investigated the trends of oral cancer in the Taiwanese general population and the possible link with diabetes.
The trend of age-standardized oral cancer incidence in 1979-2007 in Taiwan was calculated from the Taiwan Cancer Registry database. A total of 494,817 men and 503,723 women without oral cancer from a random sample of 1,000,000 individuals covered by the National Health Insurance were followed up from 2003 to 2005. Cox regression evaluated the adjusted relative risk considering potential detection bias and covariates.
The trends increased significantly in both sexes. Diabetic patients had a higher chance of oral cancer detection because they more frequently visited related medical professionals. Although diabetes status and duration were significantly associated with oral cancer in unadjusted models, none was significant after multivariable adjustment. For comorbidities, chronic obstructive pulmonary disease (a surrogate for smoking) and alcohol-related diagnoses were significant for men, and hypertension and alcohol-related diagnoses were significant for women. Additionally, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and insulin were significant with relative risk (95 % confidence interval) of 1.642 (1.174-2.295) and 2.136 (1.003-4.547), respectively, in men.
Oral cancer is increasing in Taiwan. Diabetes is not a risk factor after multivariable adjustment.
The increasing trend of oral cancer may not be ascribed to diabetes. The association between oral cancer and some comorbidities and medications requires confirmation and may provide strategies for the prevention of oral cancer.
糖尿病与口腔癌之间的关联鲜有研究。本研究旨在调查台湾一般人群中口腔癌的趋势及其与糖尿病之间的可能联系。
我们从台湾癌症登记数据库中计算了 1979 年至 2007 年台湾地区年龄标准化口腔癌发病率的趋势。从涵盖在全民健康保险范围内的 100 万个体中随机抽取的 1000000 名个体中，选择无口腔癌的 494817 名男性和 503723 名女性作为研究对象，对其随访至 2003 年至 2005 年。采用 Cox 回归分析，在考虑潜在检测偏倚和协变量的情况下评估调整后的相对风险。
无论男女，口腔癌的发病趋势均呈显著上升趋势。糖尿病患者更频繁地就诊于相关医疗专业人员，因此他们被发现口腔癌的几率更高。尽管在未调整模型中糖尿病状态和病程与口腔癌显著相关，但在多变量调整后均无统计学意义。对于合并症，男性中慢性阻塞性肺疾病（吸烟的替代指标）和酒精相关诊断显著，女性中高血压和酒精相关诊断显著。此外，男性中血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂和胰岛素的相对风险（95%置信区间）分别为 1.642（1.174-2.295）和 2.136（1.003-4.547）。
台湾地区口腔癌的发病率呈上升趋势。多变量调整后，糖尿病并非发病的危险因素。口腔癌与某些合并症和药物之间的关联需要进一步证实，这可能为口腔癌的预防策略提供依据。
口腔癌发病率的上升趋势可能并非归因于糖尿病。口腔癌与某些合并症和药物之间的关联需要进一步证实，并可能为口腔癌的预防提供策略。
