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. 2024 Mar 1;47(3):353-361.
doi: 10.2337/dc23-0386.

Association Between Age at Diabetes Diagnosis and Subsequent Incidence of Cancer: A Longitudinal Population-Based Cohort

Yanyun Li  1 , Jingyan Tian  2   3 , Tianzhichao Hou  2   3 , Kai Gu  1 , Qinghua Yan  1 , Siming Sun  4 , Jiange Zhang  5 , Jiao Sun  6 , Lili Liu  1 , Chang-Sheng Sheng  7 , Yi Pang  1 , Minna Cheng  1 , Chunxiao Wu  1 , Katie Harris  8 , Yan Shi  1   9 , Zachary T Bloomgarden  10 , John Chalmers  8 , Chen Fu  1   9 , Guang Ning  2   3
Affiliations

Association Between Age at Diabetes Diagnosis and Subsequent Incidence of Cancer: A Longitudinal Population-Based Cohort

Yanyun Li et al. Diabetes Care. .

Abstract

Objective: Diabetes presenting at a younger age has a more aggressive nature. We aimed to explore the association of age at type 2 diabetes mellitus (T2DM) diagnosis with subsequent cancer incidence in a large Chinese population.

Research design and methods: The prospective population-based longitudinal cohort included 428,568 newly diagnosed T2DM patients from 2011 to 2018. Participants were divided into six groups according to their age at diagnosis: 20-54, 55-59, 60-64, 65-69, 70-74, and ≥75 years. The incidence of overall and 14 site-specific cancers was compared with the Shanghai general population including 100,649,346 person-years.

Results: A total of 18,853 and 582,643 overall cancer cases were recorded in the T2DM cohort and the general population. The age-standardized rate of overall cancer in T2DM patients was 501 (95% CI: 491, 511) per 100,000 person-years, and the standardized incidence ratio (SIR) was 1.10 (1.09, 1.12). Younger age at T2DM diagnosis was associated with higher incidence of overall and site-specific cancers. SIRs for overall cancer with T2DM diagnosis at ages 20-54, 55-59, 60-64, 65-69, 70-74, and ≥75 years were 1.48 (1.41, 1.54), 1.30 (1.25, 1.35), 1.19 (1.15, 1.23), 1.16 (1.12, 1.20), 1.06 (1.02, 1.10), and 0.86 (0.84, 0.89), respectively. Similar trends were observed for site-specific cancers, including respiratory, colorectum, stomach, liver, pancreatic, bladder, central nervous system, kidney, and gallbladder cancer and lymphoma among both males and females.

Conclusions: Our findings highlight the necessity of stratifying management for T2DM according to age of diagnosis. As with a range of vascular outcomes, age-standardized cancer risks are greater in earlier compared with later onset T2DM.

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Conflict of interest statement

Duality of Interest. No potential conflicts of interest relevant to this article were reported.

Figures

None
Graphical abstract
Figure 1
Figure 1
All-cause cancer incidences and relative risks across different age at T2DM diagnosis groups and the relative risks of all-cause cancer among patients with BMI <25, 25 ≤ BMI <30, and BMI ≥30. A: ASR. B: SIR.
Figure 2
Figure 2
Site-specific cancer incidence and relative risks across different age at T2DM diagnosis groups.
See this image and copyright information in PMC

Comment in

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