Lin Cheng-Chieh, Chiang Jen-Huai, Li Chia-Ing, Liu Chiu-Shong, Lin Wen-Yuan, Hsieh Teng-Fu, Li Tsai-Chung
Graduate Institute of Biostatistics, College of Management, China Medical University, 91 Hsueh-Shih Road, Taichung 40421, Taiwan.
BMC Cancer. 2014 May 29;14:381. doi: 10.1186/1471-2407-14-381.
This study aims to determine cancer risks among patients with type 2 diabetes through a follow-up study on a nationwide population-based cohort that included Taiwanese diabetic patients and general population in Taiwan as well as to estimate the population attributable fraction (PAF) of site-specific cancer risks that can be attributed to type 2 diabetes in Taiwanese population by using standardized incidence ratios (SIRs, 95% CI).
Subjects with type 2 diabetes consisted of 472,979 patients aged ≥ 20 years, whereas general population consisted of 9,411,249 individuals of the same age limit but are not diabetic. Subjects were identified from 1997 to 1998 and followed up until December 31, 2007 or until the first manifestation of any cancer.
Cancer sites with increased risks in men, which were consistent with the main and sensitivity analyses, included pancreas (SIR=1.62; 95% CI=1.53 to 1.72), liver (1.61; 1.57 to 1.64), kidney (1.32; 1.25 to 1.40), oral (1.16, 1.12 to 1.21), and colorectal (1.19, 1.15 to 1.22). Cancer sites with increased risks in women included liver (1.55; 1.51 to 1.60), pancreas (1.44; 1.34 to 1.55), kidney (1.38; 1.30 to 1.46), endometrium (1.36; 1.26 to 1.47), bladder (1.19; 1.11 to 1.27), colorectal (1.16; 1.13 to 1.20), and breast (1.14; 1.09 to 1.18). Overall, PAFs were highest for liver cancer in men (4.0%) and women (3.7%), followed by pancreas (3.4%) and kidney (1.6%) cancers in men, and then for endometrium (1.8%) and kidney (1.8%) cancers in women.
Our data suggested that increased cancer risks are associated with type 2 diabetes.
本研究旨在通过对一个基于全国人口的队列进行随访研究来确定2型糖尿病患者的癌症风险,该队列包括台湾糖尿病患者和台湾普通人群,并使用标准化发病比(SIRs,95%CI)来估计台湾人群中可归因于2型糖尿病的特定部位癌症风险的人群归因分数(PAF)。
2型糖尿病患者包括472,979名年龄≥20岁的患者,而普通人群包括9,411,249名年龄限制相同但无糖尿病的个体。研究对象于1997年至1998年确定,并随访至2007年12月31日或直至任何癌症的首次出现。
男性中风险增加的癌症部位,在主要分析和敏感性分析中一致的包括胰腺(SIR = 1.62;95%CI = 1.53至1.72)、肝脏(1.61;1.57至1.64)、肾脏(1.32;1.25至1.40)、口腔(1.16,1.12至1.21)和结肠直肠癌(1.19,1.15至1.22)。女性中风险增加的癌症部位包括肝脏(1.55;1.51至1.60)、胰腺(1.44;1.34至1.55)、肾脏(1.38;1.30至1.46)、子宫内膜(1.36;1.26至1.47)、膀胱(1.19;1.11至1.27)、结肠直肠癌(1.16;1.13至1.20)和乳腺癌(1.14;1.09至1.18)。总体而言,男性中肝癌的PAF最高(4.0%),女性中肝癌的PAF也最高(3.7%),其次是男性中的胰腺癌(3.4%)和肾癌(1.6%),然后是女性中的子宫内膜癌(1.8%)和肾癌(1.8%)。
我们的数据表明,癌症风险增加与2型糖尿病有关。