From the Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark.
Epidemiology. 2021 Sep 1;32(5):705-711. doi: 10.1097/EDE.0000000000001375.
Diabetes may increase risk of human papillomavirus (HPV)-related precancer and cancer. We estimated incidence of penile and anal high-grade intraepithelial neoplasia (hgPeIN, hgAIN) and squamous cell carcinoma (SCC) in men with diabetes compared with the entire Danish male population without diabetes.
In this registry-based cohort study, we included all men born 1916-2001 and residing in Denmark (n = 2,528,756). From nationwide registries, we retrieved individual-level information on diabetes, educational level, and diagnoses of hgPeIN, hgAIN, penile SCC, and anal SCC. We used Poisson regression models to estimate incidence of hgPeIN, hgAIN, penile SCC, and anal SCC as a function of diabetes status, attained age, calendar period, and education. We estimated incidence rate ratios (IRRs) of each outcome in men with diabetes compared with nondiabetic men, both for diabetes overall and separately for type 1 (T1D) and type 2 diabetes (T2D).
Men with diabetes had increased incidence rate of penile SCC compared with nondiabetic men (IRR = 1.5, 95% CI = 1.2, 1.9). We saw similar trends for anal SCC, hgPeIN, and hgAIN. The combined incidence rate of penile and anal SCC was increased in men with T2D (IRR = 1.5, 95% CI = 1.3, 1.8), but not with T1D (IRR = 0.53, 95% CI = 0.20, 1.4) compared with men without diabetes.
The incidence of penile and anal high-grade intraepithelial neoplasia and SCC in men with diabetes was increased compared with men without diabetes. For penile and anal SCCs, this was primarily due to an increased risk in men with T2D.
糖尿病可能会增加人乳头瘤病毒（HPV）相关癌前病变和癌症的风险。我们评估了患有糖尿病的男性发生阴茎和肛门高级别上皮内瘤变（hgPeIN、hgAIN）和鳞状细胞癌（SCC）的发病率，与没有糖尿病的丹麦所有男性人群进行了比较。
在这项基于登记的队列研究中，我们纳入了所有 1916 年至 2001 年出生并居住在丹麦的男性（n=2528756）。我们从全国性登记处获取了个体的糖尿病、教育程度以及 hgPeIN、hgAIN、阴茎 SCC 和肛门 SCC 诊断信息。我们使用泊松回归模型，根据糖尿病状态、实际年龄、日历时间和教育程度，估计 hgPeIN、hgAIN、阴茎 SCC 和肛门 SCC 的发病率。我们估计了患有糖尿病的男性与非糖尿病男性相比，每种结局的发病率比值比（IRR），包括糖尿病总体情况以及 1 型（T1D）和 2 型糖尿病（T2D）的分别情况。
与非糖尿病男性相比，患有糖尿病的男性发生阴茎 SCC 的发病率更高（IRR=1.5，95%CI=1.2，1.9）。我们发现肛门 SCC、hgPeIN 和 hgAIN 也存在类似的趋势。与非糖尿病男性相比，患有 T2D 的男性发生阴茎和肛门 SCC 的合并发病率更高（IRR=1.5，95%CI=1.3，1.8），而 T1D 患者的发病率则无明显差异（IRR=0.53，95%CI=0.20，1.4）。
与非糖尿病男性相比，患有糖尿病的男性发生阴茎和肛门高级别上皮内瘤变和 SCC 的发病率更高。对于阴茎和肛门 SCC，这主要是由于 T2D 患者的风险增加所致。
