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芬兰 2 型糖尿病患者在 1989-2014 年间的癌症发病率。

Cancer incidence among Finnish people with type 2 diabetes during 1989-2014.

机构信息

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.

出版信息

Eur J Epidemiol. 2019 Mar;34(3):259-265. doi: 10.1007/s10654-018-0438-0. Epub 2018 Sep 4.

Abstract

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.

摘要

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。

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