Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
Cancer Sci. 2013 Nov;104(11):1499-507. doi: 10.1111/cas.12241. Epub 2013 Aug 25.
Although a growing body of evidence suggests a link between diabetes and cancer, it is not clear whether diabetes independently increases the risk of cancer. We conducted a comprehensive assessment of the association between pre-existing diabetes and total and site-specific cancer risk based on a pooled analysis of eight cohort studies in Japan (>330 000 subjects). We estimated a summary hazard ratio by pooling study-specific hazard ratios for total and site-specific cancer by using a random-effects model. A statistically increased risk was observed for cancers at specific sites, such as colon (hazard ratio; HR = 1.40), liver (HR = 1.97), pancreas (HR = 1.85) and bile duct (HR = 1.66; men only). Increased risk was also suggested for other sites, and diabetes mellitus was associated with an overall 20% increased risk in total cancer incidence in the Japanese population. The association between these two diseases has important implications for reiterating the importance of controlling lifestyle factors and may suggest a possible strategy for cancer screening among patients with diabetes. Studies continuously investigating the risk factors for diabetes are also important.
虽然越来越多的证据表明糖尿病和癌症之间存在关联,但尚不清楚糖尿病是否会独立增加癌症的风险。我们基于日本的 8 项队列研究(>330000 名受试者)的汇总分析,对既往糖尿病与总体和特定部位癌症风险之间的关联进行了全面评估。我们使用随机效应模型对汇总分析中的特定部位癌症的研究特异性危害比进行了汇总,以估算出综合危害比。观察到特定部位癌症的风险增加,如结肠(危害比;HR = 1.40)、肝脏(HR = 1.97)、胰腺(HR = 1.85)和胆管(HR = 1.66;仅限男性)。其他部位也提示存在风险增加,并且在日本人群中,糖尿病与总体癌症发病率增加 20%有关。这两种疾病之间的关联对再次强调控制生活方式因素的重要性具有重要意义,并且可能提示针对糖尿病患者进行癌症筛查的一种可能策略。对糖尿病风险因素进行持续研究也很重要。