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Meta-Analysis
. 2021 Jan 4;31(1):14-22.
doi: 10.1016/j.numecd.2020.09.023. Epub 2020 Sep 25.

Risk of cancer incidence and mortality associated with diabetes: A systematic review with trend analysis of 203 cohorts

Suping Ling  1 , Karen Brown  2 , Joanne K Miksza  3 , Lynne M Howells  4 , Amy Morrison  5 , Eyad Issa  6 , Thomas Yates  7 , Kamlesh Khunti  8 , Melanie J Davies  9 , Francesco Zaccardi  10
Affiliations
Meta-Analysis

Risk of cancer incidence and mortality associated with diabetes: A systematic review with trend analysis of 203 cohorts

Suping Ling et al. Nutr Metab Cardiovasc Dis. .

Abstract

Aim: Whether the relative risk of cancer incidence and mortality associated with diabetes has changed over time is unknown.

Data synthesis: On August 12th, 2020, we electronically searched for observational studies reporting on the association between diabetes and cancer. We estimated temporal trends in the relative risk of cancer incidence or mortality associated with diabetes and calculated the ratio of relative risk (RRR) comparing different periods. As many as 193 eligible articles, reporting data on 203 cohorts (56,852,381 participants; 3,735,564 incident cancer cases; 185,404 cancer deaths) and covering the period 1951-2013, were included. The relative risk of all-site cancer incidence increased between 1980 and 2000 [RRR 1990 vs.1980: (1.24; 95% CI: 1.16, 1.34); 2000 vs.1990: (1.23; 1.15, 1.31)] and stabilised thereafter at a relative risk of 1.2; the relative risk of all-site cancer mortality was constant at about 1.2 from 1980 to 2010. Both magnitudes and trends in relative risk varied across cancer sites: the relative risk of colorectal, female breast, and endometrial cancer incidence and pancreatic cancer mortality was constant during the observed years; it increased for bladder, stomach, kidney, and pancreatic cancer incidence until 2000; and decreased for liver while increased for prostate, colon and gallbladder cancer incidence after 2000.

Conclusions: Alongside the increasing prevalence of diabetes, the temporal patterns of the relative risk of cancer associated with diabetes may have contributed to the current burden of cancer in people with diabetes.

Keywords: Cancer; Diabetes; Relative risk; Systematic review; Trend analysis.

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Conflict of interest statement

Declaration of competing interest SL, KB, JKM, LH, AM, EI, TY, and FZ declare no conflict of interest relevant to this article. KK has received honoraria and research support from AstraZeneca, Boehringer Ingelheim, Germany, Eli Lilly, Janssen, Merck Sharp & Dohme, USA, Novartis, Novo Nordisk, Roche and Sanofi, France. MJD has acted as consultant, advisory board member and speaker for Novo Nordisk, Sanofi–Aventis, France, Lilly, Merck Sharp & Dohme, USA, Boehringer Ingelheim, Germany, AstraZeneca and Janssen, an advisory board member for Servier and as a speaker for Mitsubishi Tanabe Pharma Corporation and Takeda Pharmaceuticals International Inc. She has received grants in support of investigator and investigator–initiated trials from Novo Nordisk, Sanofi–Aventis, France, Lilly, Boehringer Ingelheim, Germany and Janssen.

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