Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy.
Department of Clinical and Biological Sciences, University of Turin, Turin, Italy; Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Turin, Italy.
Diabetes Res Clin Pract. 2018 Sep;143:369-377. doi: 10.1016/j.diabres.2018.03.002. Epub 2018 Mar 27.
Type 2 diabetes (T2D) is a major cause of complications and death in many countries. The possible causal relation between T2D and cancer has been the aim of many research investigations. In view of the importance of the topic we carried out a narrative review of observational studies to summarize the available evidence of the association between T2D and cancer. To deal with the problem of abundance of published studies, we reviewed up to December 2017, the literature of meta-analyses of observational studies first, then we reviewed cohort studies not reported in meta-analyses because of more recent publication. We found that the association of T2D with risk of colorectal cancer was robust, whereas the evidence of the associations with other cancer sites was lower. Some of the observed associations could be overestimated, due to publication bias, unmeasured confounders (such as obesity) and surveillance bias. In conclusion a probable causal association of T2D with risk of colorectal cancer was confirmed. A possible causal association with pancreatic, endometrial, hepatocellular and gallbladder carcinoma was also found. Substantial uncertainty exists for other cancer sites.
2 型糖尿病（T2D）是许多国家并发症和死亡的主要原因。T2D 与癌症之间可能存在因果关系，这一直是许多研究调查的目标。鉴于该主题的重要性，我们进行了观察性研究的叙述性综述，以总结 T2D 与癌症之间关联的现有证据。为了解决发表研究过多的问题，我们首先综述了截至 2017 年 12 月的观察性研究荟萃分析的文献，然后综述了由于最近发表而未在荟萃分析中报告的队列研究。我们发现，T2D 与结直肠癌风险的关联是可靠的，而与其他癌症部位的关联证据则较低。由于发表偏倚、未测量的混杂因素（如肥胖）和监测偏倚，一些观察到的关联可能被高估了。总之，T2D 与结直肠癌风险之间可能存在因果关系。还发现 T2D 与胰腺癌、子宫内膜癌、肝细胞癌和胆囊癌之间可能存在因果关系。对于其他癌症部位，存在很大的不确定性。
