Diabetes is associated with increased liver cancer incidence and mortality in adults: A report from Asia Cohort Consortium

Nhan Thi Ho¹, Sarah Krull Abe², Md Shafiur Rahman^{2

3}, Rashedul Islam^{2

4}, Eiko Saito⁵, Prakash C Gupta⁶, Mangesh S Pednekar⁶, Norie Sawada⁷, Shoichiro Tsugane^{7

8}, Akiko Tamakoshi⁹, Takashi Kimura⁹, Xiao-Ou Shu¹⁰, Yu-Tang Gao¹¹, Woon-Puay Koh^{12

13}, Hui Cai¹⁰, Wanqing Wen¹⁰, Ritsu Sakata¹⁴, Ichiro Tsuji¹⁵, Reza Malekzadeh¹⁶, Akram Pourshams¹⁷, Seiki Kanemura¹⁵, Jeongseon Kim¹⁸, Yu Chen¹⁹, Hidemi Ito^{20

21}, Isao Oze²⁰, Chisato Nagata²², Keiko Wada²², Yumi Sugawara²³, Sue K Park²⁴, Aesun Shin^{24

25}, Jian-Min Yuan^{26

27}, Renwei Wang²⁸, Sun-Seog Kweon²⁹, Min-Ho Shin²⁹, Hossein Poustchi³⁰, Hossein Molavi Vardanjani³¹, Habibul Ahsan³², Kee Seng Chia³³, Keitaro Matsuo^{34

35}, You-Lin Qiao³⁶, Nathaniel Rothman³⁷, Wei Zheng³⁸, Manami Inoue², Daehee Kang³⁹, Paolo Boffetta^{40

41}

Affiliations

¹ Research Management Department, Vinmec Healthcare System, Hanoi, Vietnam.
² Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
³ Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.
⁴ Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan.
⁵ Institute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo, Japan.
⁶ Healis-Sekhsaria Institute for Public Health, Navi Mumbai, India.
⁷ Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
⁸ Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan.
⁹ Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan.
¹⁰ Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
¹¹ Department of Epidemiology, Shanghai Cancer Institute Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹² Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
¹³ Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore.
¹⁴ Radiation Effects Research Foundation, Hiroshima, Japan.
¹⁵ Tohoku University Graduate School of Medicine, Sendai, Japan.
¹⁶ Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
¹⁷ Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
¹⁸ Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, South Korea.
¹⁹ Department of Population Health and Environmental Medicine, New York University, New York, New York, USA.
²⁰ Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan.
²¹ Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
²² Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
²³ Department of Health Informatics and Public Health, Division of Epidemiology, Tohoku University Graduate School of Public Health, Sendai, Japan.
²⁴ Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
²⁵ Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
²⁶ Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
²⁷ Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
²⁸ Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
²⁹ Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
³⁰ Digestive Disease Research institute Tehran University of Medical Science, Tehran, Iran.
³¹ MD-MPH Dual Degree Program, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Science, Shiraz, Iran.
³² Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA.
³³ Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
³⁴ Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
³⁵ Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
³⁶ School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
³⁷ Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA.
³⁸ Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
³⁹ Seoul National University College of Medicine, Seoul, Republic of Korea.
⁴⁰ Stony Brook Cancer Center, Stony Brook University, New York, New York, USA.
⁴¹ Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

PMID: 38661292
DOI: 10.1002/ijc.34965

Meta-Analysis

Diabetes is associated with increased liver cancer incidence and mortality in adults: A report from Asia Cohort Consortium

Nhan Thi Ho et al. Int J Cancer. 2024.

. 2024 Sep 1;155(5):854-870.

doi: 10.1002/ijc.34965. Epub 2024 Apr 25.

Authors

Affiliations

¹ Research Management Department, Vinmec Healthcare System, Hanoi, Vietnam.
² Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
³ Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.
⁴ Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan.
⁵ Institute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo, Japan.
⁶ Healis-Sekhsaria Institute for Public Health, Navi Mumbai, India.
⁷ Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
⁸ Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan.
⁹ Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan.
¹⁰ Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
¹¹ Department of Epidemiology, Shanghai Cancer Institute Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹² Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
¹³ Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore.
¹⁴ Radiation Effects Research Foundation, Hiroshima, Japan.
¹⁵ Tohoku University Graduate School of Medicine, Sendai, Japan.
¹⁶ Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
¹⁷ Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
¹⁸ Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, South Korea.
¹⁹ Department of Population Health and Environmental Medicine, New York University, New York, New York, USA.
²⁰ Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan.
²¹ Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
²² Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
²³ Department of Health Informatics and Public Health, Division of Epidemiology, Tohoku University Graduate School of Public Health, Sendai, Japan.
²⁴ Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
²⁵ Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
²⁶ Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
²⁷ Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
²⁸ Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
²⁹ Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
³⁰ Digestive Disease Research institute Tehran University of Medical Science, Tehran, Iran.
³¹ MD-MPH Dual Degree Program, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Science, Shiraz, Iran.
³² Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA.
³³ Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
³⁴ Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
³⁵ Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
³⁶ School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
³⁷ Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA.
³⁸ Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
³⁹ Seoul National University College of Medicine, Seoul, Republic of Korea.
⁴⁰ Stony Brook Cancer Center, Stony Brook University, New York, New York, USA.
⁴¹ Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

PMID: 38661292
DOI: 10.1002/ijc.34965

Abstract

There has been growing evidence suggesting that diabetes may be associated with increased liver cancer risk. However, studies conducted in Asian countries are limited. This project considered data of 968,738 adults pooled from 20 cohort studies of Asia Cohort Consortium to examine the association between baseline diabetes and liver cancer incidence and mortality. Cox proportional hazard model and competing risk approach was used for pooled data. Two-stage meta-analysis across studies was also done. There were 839,194 subjects with valid data regarding liver cancer incidence (5654 liver cancer cases [48.29/100,000 person-years]), follow-up time and baseline diabetes (44,781 with diabetes [5.3%]). There were 747,198 subjects with valid data regarding liver cancer mortality (5020 liver cancer deaths [44.03/100,000 person-years]), follow-up time and baseline diabetes (43,243 with diabetes [5.8%]). Hazard ratio (HR) (95% confidence interval [95%CI]) of liver cancer diagnosis in those with vs. without baseline diabetes was 1.97 (1.79, 2.16) (p < .0001) after adjusting for baseline age, gender, body mass index, tobacco smoking, alcohol use, and heterogeneity across studies (n = 586,072; events = 4620). Baseline diabetes was associated with increased cumulative incidence of death due to liver cancer (adjusted HR (95%CI) = 1.97 (1.79, 2.18); p < .0001) (n = 595,193; events = 4110). A two-stage meta-analytic approach showed similar results. This paper adds important population-based evidence to current literature regarding the increased incidence and mortality of liver cancer in adults with diabetes. The analysis of data pooled from 20 studies of different Asian countries and the meta-analysis across studies with large number of subjects makes the results robust.

Keywords: Asia Cohort Consortium; diabetes; incidence; liver cancer; mortality.

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References

REFERENCES

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Diabetes is associated with increased liver cancer incidence and mortality in adults: A report from Asia Cohort Consortium

Affiliations

Diabetes is associated with increased liver cancer incidence and mortality in adults: A report from Asia Cohort Consortium

Authors

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical