Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2008 Dec 17;300(23):2754-64.
doi: 10.1001/jama.2008.824.

Long-term all-cause mortality in cancer patients with preexisting diabetes mellitus: a systematic review and meta-analysis

Bethany B Barone  1 , Hsin-Chieh Yeh, Claire F Snyder, Kimberly S Peairs, Kelly B Stein, Rachel L Derr, Antonio C Wolff, Frederick L Brancati
Affiliations
Meta-Analysis

Long-term all-cause mortality in cancer patients with preexisting diabetes mellitus: a systematic review and meta-analysis

Bethany B Barone et al. JAMA. .

Abstract

Context: Diabetes mellitus appears to be a risk factor for some cancers, but the effect of preexisting diabetes on all-cause mortality in newly diagnosed cancer patients is less clear.

Objective: To perform a systematic review and meta-analysis comparing overall survival in cancer patients with and without preexisting diabetes.

Data sources: We searched MEDLINE and EMBASE through May 15, 2008, including references of qualifying articles.

Study selection: English-language, original investigations in humans with at least 3 months of follow-up were included. Titles, abstracts, and articles were reviewed by at least 2 independent readers. Of 7858 titles identified in our original search, 48 articles met our criteria.

Data extraction: One reviewer performed a full abstraction and other reviewers verified accuracy. We contacted authors and obtained additional information for 3 articles with insufficient reported data.

Results: Studies reporting cumulative survival rates were summarized qualitatively. Studies reporting Cox proportional hazard ratios (HRs) or Poisson relative risks were combined in a meta-analysis. A random-effects model meta-analysis of 23 articles showed that diabetes was associated with an increased mortality HR of 1.41 (95% confidence interval [CI], 1.28-1.55) compared with normoglycemic individuals across all cancer types. Subgroup analyses by type of cancer showed increased risk for cancers of the endometrium (HR, 1.76; 95% CI, 1.34-2.31), breast (HR, 1.61; 95% CI, 1.46-1.78), and colorectum (HR, 1.32; 95% CI, 1.24-1.41).

Conclusions: Patients diagnosed with cancer who have preexisting diabetes are at increased risk for long-term, all-cause mortality compared with those without diabetes.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Study Selection
Figure 2
Figure 2. Meta-analysis and Pooled Hazard Ratio of Long-term, All-Cause Mortality in 23 Studies Comparing Cancer Patients With and Without Preexisting Diabetes Mellitus
The 23 studies provided 25 estimates. Weights are from random-effects analysis. Data markers are proportional to study sample sizes. CI indicates confidence interval. aPatients who had no resection, Childs Pugh B. bPatients who had no resection, Childs Pugh A. cPatients undergoing surgical resection.
See this image and copyright information in PMC

Comment in

References

    1. National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics Fact Sheet: General Information and National Estimates on Diabetes in the United States, 2005. Bethesda, MD: US Dept of Health and Human Services, National Institutes of Health; 2005.
    1. Larsson SC, Mantzoros CS, Wolk A. Diabetes mellitus and risk of breast cancer: a meta-analysis. Int J Cancer. 2007;121(4):856–862. - PubMed
    1. Larsson SC, Orsini N, Wolk A. Diabetes mellitus and risk of colorectal cancer: a meta-analysis. J Natl Cancer Inst. 2005;97(22):1679–1687. - PubMed
    1. Friberg E, Orsini N, Mantzoros CS, Wolk A. Diabetes mellitus and risk of endometrial cancer: a meta-analysis. Diabetologia. 2007;50(7):1365–1374. - PubMed
    1. El-Serag HB, Hampel H, Javadi F. The association between diabetes and hepatocellular carcinoma: a systematic review of epidemiologic evidence. Clin Gastroenterol Hepatol. 2006;4(3):369–380. - PubMed

Publication types