Tseng Chin-Hsiao
Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Division of Environmental Health and Occupational Medicine of the National Health Research Institutes, Taipei, Taiwan.
PLoS One. 2014 Jul 3;9(7):e101553. doi: 10.1371/journal.pone.0101553. eCollection 2014.
The trend of lung cancer incidence in Taiwan is unknown, and the association between type 2 diabetes/insulin use and lung cancer is rarely studied.
The trends of lung cancer incidence in 1979-2007 in the Taiwanese general population were calculated. A random sample of 1,000,000 subjects covered by the National Health Insurance in 2005 was recruited. A total of 494,002 men and 502,948 women and without lung cancer were followed for the annual cumulative incidence of lung cancer in 2005, with calculation of the risk ratios between diabetic and non-diabetic subjects. Logistic regression estimated the adjusted odds ratios for risk factors.
The trends increased significantly in both sexes (P<0.0001). The sex-specific annual cumulative incidence increased with age in either the diabetic or non-diabetic subjects, but the risk ratios attenuated with age. In logistic regressions, diabetes was associated with a significantly higher risk, with odds ratios (95% confidence interval) for diabetes duration <1, 1-3, 3-5 and ≥5 years versus non-diabetes of 2.189 (1.498-3.200), 1.420 (1.014-1.988), 1.545 (1.132-2.109), and 1.329 (1.063-1.660), respectively. Such an association was not related to a higher detection with chest X-ray examination. Insulin use and medications including oral anti-diabetic drugs, statin, fibrate, and anti-hypertensive agents were not significantly associated with lung cancer. Age, male sex, and chronic obstructive pulmonary disease were positively; but dyslipidemia, stroke and higher socioeconomic status were negatively associated with lung cancer.
Diabetes is significantly associated with a higher risk of lung cancer, but insulin use does not increase the risk.
台湾地区肺癌发病率的趋势尚不清楚，并且2型糖尿病/胰岛素使用与肺癌之间的关联很少被研究。
计算了1979 - 2007年台湾普通人群中肺癌发病率的趋势。招募了2005年参加国民健康保险的100万受试者的随机样本。对总共494,002名男性和502,948名女性且无肺癌者进行随访，以观察2005年肺癌的年度累积发病率，并计算糖尿病患者与非糖尿病患者之间的风险比。逻辑回归估计了风险因素的调整比值比。
两性的发病率趋势均显著上升（P<0.0001）。无论糖尿病患者还是非糖尿病患者，按性别划分的年度累积发病率均随年龄增加，但风险比随年龄降低。在逻辑回归中，糖尿病与显著更高的风险相关，糖尿病病程<1年、1 - 3年、3 - 5年和≥5年者与非糖尿病者相比的比值比（95%置信区间）分别为2.189（1.498 - 3.200）、1.420（1.014 - 1.988）、1.545（1.132 - 2.109）和1.329（1.063 - 1.660）。这种关联与胸部X线检查的更高检出率无关。胰岛素使用以及包括口服降糖药、他汀类药物、贝特类药物和抗高血压药物在内的药物与肺癌无显著关联。年龄、男性性别和慢性阻塞性肺疾病与肺癌呈正相关；但血脂异常、中风和较高的社会经济地位与肺癌呈负相关。
糖尿病与肺癌风险显著升高相关，但胰岛素使用不会增加风险。
