Background: The aim of this study was to investigate the risk of 23 common types of cancer among patients with type 2 diabetes (T2D) compared with the general Chinese population.
Methods: Based on the Shanghai Hospital Link database, 410 191 patients with T2D (age 20-99 years) were identified from July 2013 to December 2016, and were followed-up for cancer incidence until December 2017.
Results: In all, 8485 cases of newly diagnosed cancer were identified. The standardized incidence ratios (SIRs) of total cancer were 1.34 and 1.62 among males and females, respectively. Among males with T2D, the risk of cancer of the prostate (highest SIR of 1.86), blood (leukemia, lymphoma), skin, thyroid, kidney, liver, pancreas, lung, colorectum, and stomach was increased significantly. There was a significant decrease in the risk of esophageal cancer. In females with T2D, there were significantly greater risks of cancer of the nasopharynx (highest SIR of 2.33), liver, esophagus, thyroid, lung, pancreas, blood (lymphoma, leukemia), uterus, colorectum, breast, cervix, and stomach. In contrast, there was significantly decrease risk of gallbladder cancer in females with T2D.
Conclusions: This study shows significantly increased risks of overall and some site-specific cancers among patients with T2D. We suggest that establishing strategies for regular cancer-specific screening and prevention care among patients with T2D are necessary.
背景: 本研究旨在研究相对于普通人群，2型糖尿病患者发生23种常见癌症的患病风险。 方法: 基于上海申康医联数据库，从2013年7月至2016年12月共纳入410 191例2型糖尿病患者(年龄20-99岁)，并随访至2017年12月追查癌症的病例。 结果: 研究期间共确诊8485例新发癌症。男性和女性2型糖尿病患者的总体癌症标准化发病率(standardized incidence ratios，SIRs)分别为1.34和1.62。在男性糖尿病患者中，前列腺癌(SIR最高:1.86)、血癌(白血病、淋巴瘤)、皮肤癌、甲状腺癌、肾癌、肝癌、胰腺癌、肺癌、结直肠癌和胃癌的风险显著增加，食管癌的风险显著降低。在女性糖尿病患者中，鼻咽癌(SIR最高:2.33)、肝癌、食管癌、甲状腺癌、肺癌、胰腺癌、血癌(白血病、淋巴瘤)、子宫癌、结直肠癌、乳腺癌、子宫颈癌和胃癌的风险明显升高。相比之下，女性患者患胆囊癌的风险明显降低。 结论: 本研究结果显示，2型糖尿病患者的总体癌症和某些特定部位的癌症风险显著增加。我们建议在临床中建立针对2型糖尿病患者的定期癌症筛查和预防策略是必要的。.
Keywords: 2型糖尿病; cancer; risk; type 2 diabetes; 癌症; 风险.
© 2019 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.