Diabetes mellitus and the risk of cancer - Results from a large-scale population-based cohort study in Japan
Diabetes mellitus and the risk of cancer - Results from a large-scale population-based cohort study in Japan
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DOI：
10.1001/archinte.166.17.1871
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发表时间：
2006-09-25
影响因子：
--
通讯作者：
Tsugane, Shoichiro
中科院分区：
文献类型：
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作者：
Inoue, Manami;Iwasaki, Motoki;Tsugane, Shoichiro
背景：人们长期以来一直推测糖尿病 (DM) 与癌症之间存在关联，但尚未获得确凿的证据。 方法：我们在日本公共卫生中心的前瞻性研究中前瞻性地研究了 DM 病史与随后患癌症风险之间的关联。 1990 年 1 月至 1994 年 12 月间，共有 97 771 名年龄在 40 至 69 岁之间的日本普通人（46 548 名男性和 51 223 名女性）接受了基线调查问卷的随访，直至 2003 年 12 月 31 日为止。在基线时，6.7% 的男性和 3.1% 的女性有 DM 病史。 结果：总共 6462 例病例确定了新诊断的癌症。在男性中，有 DM 病史的人的癌症总发病风险增加了 27%（n=3907 [366 名患有 DM]；风险比 [HR]，1.27；95% 置信区间 [CI]，1.14-1.42）。肝癌患者的 HR 特别高（n = 312 [52 名糖尿病患者]；HR，2.24；95% CI，1.64-3.04），胰腺癌 n = 118 [16 名糖尿病患者]；心率，1.85； 95% CI，1.07-3.20）和肾脏（n=99 [13 名糖尿病患者]；HR，1.92；95% CI，1.06-3.46）。我们还观察到结肠癌的风险中度增加（n = 491 [46 名糖尿病患者]；HR，1.36；95% CI，1.00-1.85）和具有临界意义的胃癌风险（n = 977 [87 名糖尿病患者]；HR，1.23；95% CI，0.98-1.54）。在女性中，观察到总癌症发病率的风险显着增加（n=2555 [104 名糖尿病患者]；HR，1.21；95% CI，0.99-1.47），而胃癌（n=362 [20 名糖尿病患者]；HR，1.61；95% CI，1.02-2.54）和肝癌的发病率具有统计学显着性(n=120 [10 与 DM]；心率，1.94； 95% CI, 1.00-3.73) 卵巢癌的发病率观察到临界显着性，n=74 [5 例患有 DM]；心率，2.42； 95% CI, 0.96-6.09）。结论：日本普通人群中的 DM 患者罹患全癌和特定部位癌症的风险可能增加。
Background: An association between diabetes mellitus (DM) and cancer has long been speculated, but no conclusive evidence has been obtained.Methods: We prospectively examined the association between a history of DM and subsequent risk of cancer in the Japan Public Health Center-Based Prospective Study. A total of 97 771 general Japanese persons (46 548 men and 51 223 women) aged 40 to 69 years who responded to the baseline questionnaire, from January 1990 to December 1994, were followed up for cancer incidence through December 31, 2003. At baseline, 6.7% of men and 3.1% of women had a history of DM.Results: A total of 6462 cases of newly diagnosed cancer were identified. In men, a 27% increase in the risk of total cancer incidence was observed in those with a history of DM (n=3907 [366 with DM]; hazard ratio [HR], 1.27; 95% confidence interval [CI], 1.14-1.42). The HR was especially high for those with cancer of the liver (n=312 [52 with DM]; HR, 2.24; 95% CI, 1.64- 3.04), pancreas n=118 [16 with DM]; HR, 1.85; 95% CI, 1.07-3.20), and kidney (n=99 [13 with DM]; HR, 1.92; 95% CI, 1.06-3.46). We also observed a moderately increased risk of colon cancer (n=491 [46 with DM]; HR, 1.36; 95% CI, 1.00-1.85) and of stomach cancer with borderline significance (n=977 [87 with DM]; HR, 1.23; 95% CI, 0.98-1.54). In women, a borderline significant increase in risk was observed for the incidence of total cancer (n=2555 [104 with DM]; HR, 1.21; 95% CI, 0.99-1.47), while statistical significance was observed for the incidence of stomach cancer (n=362 [20 with DM]; HR, 1.61; 95% CI, 1.02-2.54) and liver cancer (n=120 [10 with DM]; HR, 1.94; 95% CI, 1.00-3.73) and borderline significance was observed for the incidence of ovarian cancer n=74 [5 with DM]; HR, 2.42; 95% CI, 0.96-6.09).Conclusion: Patients with DM drawn from the general Japanese population may be at increased risk of total cancer and of cancer in specific sites.