Vicentini Massimo, Ballotari Paola, Venturelli Francesco, Ottone Marta, Manicardi Valeria, Gallo Marco, Greci Marina, Pinotti Mirco, Pezzarossi Annamaria, Giorgi Rossi Paolo
Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy.
Medical Diabetologist Association Coordinator, Diabetologist, 42122 Reggio Emilia, Italy.
Cancers (Basel). 2022 May 31;14(11):2719. doi: 10.3390/cancers14112719.
To assess the effect of insulin on cancer incidence in type 1 (T1DM) and type 2 diabetes (T2DM).
The cohort included all 401,172 resident population aged 20-84 in December 2009 and still alive on December 2011, classified for DM status. Drug exposure was assessed for 2009-2011 and follow up was conducted from 2012 to 2016 through the cancer registry. Incidence rate ratios (IRRs) were computed for all sites and for the most frequent cancer sites.
among residents, 21,190 people had diabetes, 2282 of whom were taking insulin; 1689 cancers occurred, 180 among insulin users. The risk for all site was slightly higher in people with T2DM compared to people without DM (IRR 1.21, 95% CI 1.14-1.27), with no excess for T1DM (IRR 0.73, 95% CI 0.45-1.19). The excess in T2DM remained when comparing with diet-only treatment. In T2DM, excess incidence was observed for liver and pancreas and for NETs: 1.76 (95% CI 1.44-2.17) and 1.37 (95% CI 0.99-1.73), respectively. For bladder, there was an excess both in T1DM (IRR 3.00, 95% CI 1.12, 8.02) and in T2DM (IRR1.27, 95% CI 1.07-1.50).
Insulin was associated with a 20% increase in cancer incidence. The risk was higher for liver, pancreatic, bladder and neuroendocrine tumours.
评估胰岛素对1型糖尿病（T1DM）和2型糖尿病（T2DM）患者癌症发病率的影响。
该队列研究纳入了2009年12月年龄在20 - 84岁且在2011年12月仍存活的所有401,172名居民，并根据糖尿病状态进行分类。评估了2009 - 2011年期间的药物暴露情况，并通过癌症登记处对2012年至2016年进行随访。计算了所有部位以及最常见癌症部位的发病率比值（IRR）。
在居民中，21,190人患有糖尿病，其中2282人使用胰岛素；共发生1689例癌症，胰岛素使用者中有180例。与非糖尿病患者相比，T2DM患者所有部位的发病风险略高（IRR 1.21，95% CI 1.14 - 1.27），T1DM患者无增加（IRR 0.73，95% CI 0.45 - 1.19）。与仅采用饮食治疗相比，T2DM患者的发病风险仍有增加。在T2DM患者中，肝脏、胰腺和神经内分泌肿瘤的发病率增加：分别为1.76（95% CI 1.44 - 2.17）和1.37（95% CI 0.99 - 1.73）。对于膀胱癌，T1DM（IRR 3.00，95% CI 1.12，8.02）和T2DM（IRR1.27，95% CI 1.07 - 1.50）患者的发病率均有增加。
胰岛素与癌症发病率增加20%相关。肝脏、胰腺、膀胱和神经内分泌肿瘤的发病风险更高。
