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
Review
. 2012 Jun;55(6):1619-32.
doi: 10.1007/s00125-012-2526-0. Epub 2012 Apr 4.

Diabetes and cancer (2): evaluating the impact of diabetes on mortality in patients with cancer

Collaborators, Affiliations
Review

Diabetes and cancer (2): evaluating the impact of diabetes on mortality in patients with cancer

A G Renehan et al. Diabetologia. 2012 Jun.

Abstract

In this paper we address methodological aspects of aetiological importance in the link between diabetes and mortality in patients with cancer. We identified nine key points on the cancer pathway at which confounding may arise-cancer screening use, stage at diagnosis, cancer treatment selection, cancer treatment complications and failures, peri-treatment mortality, competing risks for long-term mortality, effects of type 2 diabetes on anti-cancer therapies, effects of glucose-lowering treatments on cancer outcome and differences in tumour biology. Two types of mortality studies were identified: (1) inception cohort studies that evaluate the effect of baseline diabetes on cancer-related mortality in general populations, and (2) cohorts of patients with a cancer diagnosis and pre-existing type 2 diabetes. We demonstrate, with multiple examples from the literature, that pre-existing diabetes affects presentation, cancer treatment, and outcome of several common cancer types, often to varying extents. Diabetes is associated with increased all-cause mortality in cancer patients, but the evidence that it influences cancer-specific mortality is inconsistent. In the absence of data that address the potential biases and confounders outlined in the above framework, we caution against the reporting of cancer-related mortality as a main endpoint in analyses determining the impact of diabetes and glucose-lowering medications on risk of cancer.

PubMed Disclaimer

Similar articles

Cited by

References

    1. Diabetologia. 2010 Aug;53(8):1631-7 - PubMed
    1. N Engl J Med. 2011 Mar 03;364(9):829-841 - PubMed
    1. J Gen Intern Med. 2009 Feb;24(2):270-5 - PubMed
    1. Metabolism. 2011 Oct;60(10):1379-85 - PubMed
    1. Urology. 2003 Mar;61(3):596-600 - PubMed

Publication types

MeSH terms

LinkOut - more resources