Yang Wan-Shui, Yang Yang, Yang Gong, Chow Wong-Ho, Li Hong-Lan, Gao Yu-Tang, Ji Bu-Tian, Rothman Nat, Zheng Wei, Shu Xiao-Ou, Xiang Yong-Bing
Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China State Key Laboratory of Oncogene and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China Department of Social Science and Public Health, School of Basic Medical Science, Jiujiang University, Jiujiang, China.
Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China State Key Laboratory of Oncogene and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
BMJ Open. 2014 Jul 3;4(7):e004875. doi: 10.1136/bmjopen-2014-004875.
Observational studies of type 2 diabetes (T2D) and lung cancer risk are limited and controversial. We thus examined the association between T2D and risk of incident lung cancer using a cohort design.
Data from two ongoing population-based cohorts (the Shanghai Men's Health Study, SMHS, 2002-2006 and the Shanghai Women's Health Study, SWHS, 1996-2000) were used. Cox proportional-hazards regression models with T2D as a time-varying exposure were modelled to estimate HRs and 95% CIs.
The study population included 61 491 male participants aged 40-74 years from SMHS and 74 941 female participants aged 40-70 years from SWHS.
Lung cancer cases were identified through annual record linkage to the Shanghai Cancer Registry and Shanghai Municipal Registry of Vital Statistics, and were further verified through home visits and a review of medical charts by clinical and/or pathological experts. Outcome data until 31 December 2010 for men and women were used for the present analysis.
After a median follow-up of 6.3 years for SMHS and 12.2 years for SWHS, incident lung cancer cases were detected in 492 men and 525 women. A null association between T2D and lung cancer risk was observed in men (HR=0.87, 95% CI 0.62 to 1.21) and women (HR=0.92, 95% CI 0.69 to 1.24) after adjustments for potential confounders. Similar results were observed among never smokers.
There is little evidence that pre-existing T2D may influence the incidence of lung cancer.
关于2型糖尿病（T2D）与肺癌风险的观察性研究有限且存在争议。因此，我们采用队列设计研究了T2D与肺癌发病风险之间的关联。
使用了两项正在进行的基于人群的队列研究数据（上海男性健康研究，SMHS，2002 - 2006年；上海女性健康研究，SWHS，1996 - 2000年）。采用以T2D作为时变暴露因素的Cox比例风险回归模型来估计风险比（HRs）和95%置信区间（CIs）。
研究人群包括来自SMHS的61491名年龄在40 - 74岁的男性参与者和来自SWHS的74941名年龄在40 - 70岁的女性参与者。
通过与上海癌症登记处和上海市生命统计登记处的年度记录链接来识别肺癌病例，并通过家访以及临床和/或病理专家对病历的审查进行进一步核实。本次分析使用了截至2010年12月31日的男性和女性结局数据。
经过对SMHS中位数为6.3年、对SWHS中位数为12.
