Association between diabetes, obesity, aging, and cancer: review of recent literature

Abstract

Rates of obesity and diabetes have risen significantly in recent years and are projected to increase even further in the coming decades. Obesity and diabetes are associated with increased risk of certain tumours, with the strongest relationships demonstrated for colorectal, post-menopausal breast, and endometrial cancer. Another important risk factor for cancer development is aging. Aging is characterized by chronic inflammation and immunosenescence, and accelerated by obesity, which may further stimulate the development of cancer. In this review, we summarize recent literature on the complex interactions between obesity, diabetes, aging, and cancer risk and mortality. We will also provide an overview of both epidemiological as well as pathophysiologic data and their clinical implications. In the context of an aging population and anticipated rise in rates of obesity and diabetes, a better understanding of how these factors interact and impact on cancer risk and prognosis will be important in helping to guide therapeutic interventions.

Keywords: Cancer; aging; diabetes mellitus; obesity.

Figure 1

Interactions between aging, diabetes, obesity, and cancer. Obesity and advanced age are two risk factors for diabetes. Aging contributes to the development of diabetes due to physical inactivity, sarcopenia, which can cause insulin resistance and diabetes. In obesity, insulin resistance initially leads to hyperinsulinemia. Overtime, the pancreas is unable to continue to secrete sufficient insulin and decompensation occurs, leading to diabetes. Aging, diabetes, and obesity all contribute to carcinogenesis.