Chronic Disease Prevention Unit, National Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland.
Department of Public Health, University of Helsinki, Helsinki, Finland.
Eur J Epidemiol. 2019 Mar;34(3):259-265. doi: 10.1007/s10654-018-0438-0. Epub 2018 Sep 4.
Diabetes and cancer are common diseases both with enormous impact on health burden globally. The increased risk of several types of cancer among people with type 2 diabetes mellitus has been indicated repeatedly. This study aimed at exploring and describing the association between type 2 diabetes and cancer incidence. A cohort of 428,326 people with type 2 diabetes was identified from the Finnish National Diabetes Register and followed up through a register linkage with the Finnish Cancer Registry for cancer incidence during 1988-2014. A total of 74,063 cases of cancer occurred in this cohort in 4.48 million person-years. This accounted for 16% more than the expected cancer incidence in the Finnish general population; the standardized incidence ratio (SIR) was 1.16 (95% confidence interval [CI] 1.15-1.16). There was a statistically significant excess of cancers of lip (SIR = 1.40, CI = 1.28-1.53), liver (SIR = 2.44, CI = 2.35-2.53), pancreas (SIR = 1.75, CI = 1.70-1.79), stomach (SIR = 1.22, CI = 1.18-1.26), colon (SIR = 1.22, CI = 1.19-1.25), gallbladder and bile ducts (SIR = 1.29, CI = 1.21-1.36), non-melanoma skin (SIR = 1.18, CI = 1.15-1.22), kidney (SIR = 1.42, CI = 1.37-1.47), bladder (SIR = 1.17, CI = 1.13-1.21), and thyroid (SIR = 1.22, CI = 1.12-1.31). There was a small statistically significant decrease in prostate cancer incidence (SIR = 0.95, CI = 0.93-0.96). This study showed an association between type 2 diabetes mellitus and the incidence of cancer at numerous sites in the Finnish population.
糖尿病和癌症是两种常见疾病,在全球范围内都对健康负担产生了巨大影响。已经反复表明,2 型糖尿病患者患多种类型癌症的风险增加。本研究旨在探讨和描述 2 型糖尿病与癌症发病率之间的关系。从芬兰国家糖尿病登记处确定了 428326 名 2 型糖尿病患者的队列,并通过与芬兰癌症登记处的登记链接,在 1988-2014 年期间对癌症发病率进行随访。在这一队列中,共有 74063 例癌症发生在 448 万人年中。这比芬兰一般人群预期的癌症发病率高出 16%;标准化发病率比(SIR)为 1.16(95%置信区间[CI]1.15-1.16)。唇癌(SIR=1.40,CI=1.28-1.53)、肝癌(SIR=2.44,CI=2.35-2.53)、胰腺癌(SIR=1.75,CI=1.70-1.79)、胃癌(SIR=1.22,CI=1.18-1.26)、结肠癌(SIR=1.22,CI=1.19-1.25)、胆囊和胆管癌(SIR=1.29,CI=1.21-1.36)、非黑色素瘤皮肤癌(SIR=1.18,CI=1.15-1.22)、肾癌(SIR=1.42,CI=1.37-1.47)、膀胱癌(SIR=1.17,CI=1.13-1.21)和甲状腺癌(SIR=1.22,CI=1.12-1.31)的发病率有统计学意义的显著增加。前列腺癌发病率略有统计学意义的降低(SIR=0.95,CI=0.93-0.96)。本研究显示,在芬兰人群中,2 型糖尿病与多个部位的癌症发生之间存在关联。