Zhu Xiaoke, Heng Yu, Zhou Liang, Zhang Ming, Cao Pengyu, Tao Lei
Department of Otolaryngology, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, PR China.
Endocrine. 2020 Nov;70(2):323-330. doi: 10.1007/s12020-020-02405-2. Epub 2020 Jul 8.
The focus on diabetic mortality in cancer patients remains superficial. The objective of our study is to identify cancer patients with the highest risk of diabetic mortality compared with other cancer patients and the general US population.
The representative data of cancer patients dying from diabetes between 1975 and 2016 was retrieved from the Surveillance, Epidemiology, and End Results program. Standardized mortality ratios (SMRs) and excess risks for multiple cancer sites were calculated. Cox regression analysis was performed to identify potential risk factors of death from diabetes.
Among 9,043,788 cancer patients diagnosed between 1975 and 2016, 51,611 patients died from diabetes. the SMR of diabetic death was 2.15 compared with the general population. Malignancies of pancreas, liver, and brain had the highest SMR (>15) compared with the general population. The risk of death from diabetes was increasing in more recent years. The majority of deaths from diabetes occurred in those >45 years of age diagnosed with prostate, breast, colorectum, lung, or bladder cancer. Patients with older age, male sex, black race, higher histologic grade, unmarried status, and not undergoing surgery are at higher risk compared with other cancer survivors.
Compared to the general population, cancer patients are at elevated risk of death from diabetes throughout the follow-up period. Elderly, black, unmarried males with distant metastases and without receiving surgery are recommended with earlier detection and more efficient diabetic care, especially for those with prostate, breast, colorectum, lung, or bladder cancer.
对癌症患者糖尿病死亡率的关注仍较为表面。我们研究的目的是确定与其他癌症患者及美国普通人群相比，糖尿病死亡风险最高的癌症患者。
从监测、流行病学和最终结果计划中检索1975年至2016年期间死于糖尿病的癌症患者的代表性数据。计算多个癌症部位的标准化死亡率（SMR）和超额风险。进行Cox回归分析以确定糖尿病死亡的潜在风险因素。
在1975年至2016年期间诊断的9043788例癌症患者中，51611例死于糖尿病。与普通人群相比，糖尿病死亡的SMR为2.15。与普通人群相比，胰腺、肝脏和脑恶性肿瘤的SMR最高（>15）。近年来，糖尿病死亡风险呈上升趋势。大多数糖尿病死亡发生在年龄>45岁、被诊断患有前列腺癌、乳腺癌、结直肠癌、肺癌或膀胱癌的患者中。与其他癌症幸存者相比，年龄较大、男性、黑人种族、组织学分级较高、未婚且未接受手术的患者风险更高。
与普通人群相比，癌症患者在整个随访期间死于糖尿病的风险更高。建议对有远处转移且未接受手术的老年、黑人、未婚男性进行早期检测和更有效的糖尿病护理，尤其是对于那些患有前列腺癌、乳腺癌、结直肠癌、肺癌或膀胱癌的患者。
