Increased Risk of Site-Specific Cancer in People with Type 2 Diabetes: A National Cohort Study
Abstract
:1. Introduction
2. Research Design and Methods
2.1. Study Design and Data Source
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
Abbreviations
T2DM | Type 2 diabetes mellitus |
SIR | standardized incidence ratio |
NHIF | National Health Insurance Fund |
CI | confidence interval |
RR | relative risk |
References
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Characteristic | Males (48,467) | Females (78,823) | Total (127,290) |
---|---|---|---|
Mean age at study entry, y (SD) | 59.7 (10.4) | 64.0 (10.6) | 62.4 (10.7) |
40–49 y, No. (%) | 9639 (20) | 7971 (10) | 17,610 (14) |
50–59 y, No. (%) | 15,808 (32) | 20,617 (26) | 36,425 (29) |
60–69 y, No. (%) | 14,371 (30) | 26,254 (33) | 40,625 (32) |
70+ | 8649 (18) | 23,981 (31) | 32,630 (25) |
Mean duration of follow-up, y (SD) | 6.1 (3.9) | 6.8 (4.0) | 6.5 (3.9) |
Total No. of person-years at risk | 295,390 | 532,852 | 828,242 |
No. of cancer cases | 5959 | 6661 | 12620 |
Mean age at cancer diagnosis, y (SD) | 69.0 (8.8) | 70.4 (9.4) | 69.7 (9.1) |
Primary Site | ICD 10-AM Code | Males | Females | ||||||
---|---|---|---|---|---|---|---|---|---|
Obs | Exp | SIR | 95% CI | Obs | Exp | SIR | 95% CI | ||
All Sites | C00–C96 | 5959 | 5934 | 1.00 | 0.98–1.03 | 6661 | 5724 | 1.16 | 1.14–1.19 |
Lip | C00 | 21 | 23 | 0.93 | 0.61–1.43 | 9 | 11 | 0.79 | 0.41-1.52 |
Mouth and pharynx | C01–C14 | 73 | 149 | 0.49 | 0.39–0.62 | 32 | 40 | 0.81 | 0.57–1.14 |
Oesophagus | C15 | 46 | 93 | 0.50 | 0.37–0.66 | 16 | 20 | 0.79 | 0.49–1.29 |
Stomach | C16 | 325 | 339 | 0.96 | 0.86–1.07 | 303 | 305 | 0.99 | 0.89–1.11 |
Colon, rectum, rectosigmoid, anus | C19–C21 | 627 | 508 | 1.23 | 1.14–1.33 | 682 | 640 | 1.07 | 0.99–1.15 |
Liver | C22 | 139 | 66 | 2.11 | 1.79–2.49 | 86 | 59 | 1.45 | 1.17–1.79 |
Gallbladder, bile ducts | C23, C24 | 28 | 24 | 1.17 | 0.81–1.70 | 66 | 63 | 1.05 | 0.82–1.33 |
Pancreas | C25 | 265 | 150 | 1.77 | 1.57–1.99 | 325 | 187 | 1.74 | 1.5–61.93 |
Other digestive organs | C17, C26, C48 | 15 | 17 | 0.89 | 0.54–1.47 | 42 | 29 | 1.45 | 1.07–1.97 |
Nasal cavity, middle ear, accessory sinuses | C30, C31 | 7 | 10 | 0.68 | 0.32–1.42 | 6 | 8 | 0.76 | 0.34–1.69 |
Larynx | C32 | 63 | 111 | 0.57 | 0.44–0.73 | 6 | 7 | 0.83 | 0.37–1.85 |
Lung, trachea | C33, C34 | 436 | 828 | 0.53 | 0.48–0.58 | 183 | 211 | 0.87 | 0.75–1.00 |
Other respiratory tract | C37–C39 | 4 | 6 | 0.62 | 0.23–1.64 | 5 | 5 | 0.99 | 0.41–2.37 |
Bone and connective tissue | C40, C41, C45–C47, C49 | 28 | 29 | 0.98 | 0.68–1.42 | 33 | 36 | 0.91 | 0.65–1.28 |
Skin, melanoma | C43 | 72 | 52 | 1.40 | 1.11–1.76 | 101 | 111 | 0.91 | 0.75–1.10 |
Skin, non-melanoma | C44 | 566 | 498 | 1.14 | 1.05–1.23 | 1033 | 1049 | 0.98 | 0.93–1.05 |
Breast | C50 | 10 | 9 | 1.17 | 0.63–2.17 | 1114 | 900 | 1.24 | 1.17–1.31 |
Vulva | C51 | - | - | - | - | 53 | 45 | 1.17 | 0.89–1.53 |
Cervix uteri | C53 | - | - | - | - | 198 | 212 | 0.93 | 0.81–1.07 |
Corpus uteri | C54, C55 | - | - | - | - | 872 | 422 | 2.07 | 1.93–2.21 |
Ovary | C56 | - | - | - | - | 249 | 264 | 0.94 | 0.83–1.07 |
Other female genital organs | C52, C57–C58 | - | - | - | - | 13 | 17 | 0.76 | 0.44–1.31 |
Male genital organs | C60, C63 | 27 | 15 | 1.86 | 1.27–2.71 | - | - | - | - |
Prostate | C61 | 2164 | 2074 | 1.04 | 1.00–1.09 | - | - | - | - |
Testis | C62 | 4 | 4 | 1.04 | 0.39–2.78 | - | - | - | - |
Kidney | C64 | 336 | 231 | 1.46 | 1.31–1.62 | 312 | 218 | 1.43 | 1.28–1.60 |
Urinary bladder | C67 | 214 | 208 | 1.03 | 0.90–1.18 | 97 | 86 | 1.13 | 0.93–1.38 |
Other urinary tract | C65, C66, C68 | 10 | 10 | 0.99 | 0.53–1.84 | 13 | 11 | 1.19 | 0.69–2.05 |
Eye and adnexa | C69 | 8 | 7 | 1.13 | 0.56–2.26 | 12 | 13 | 0.95 | 0.54–1.68 |
Central nervous system | C70–C72 | 46 | 61 | 0.76 | 0.57–1.01 | 88 | 90 | 0.98 | 0.79–1.21 |
Thyroid | C73 | 36 | 20 | 1.83 | 1.32–2.54 | 196 | 140 | 1.40 | 1.22–1.62 |
Other endocrine organs | C74, C75 | 10 | 5 | 1.96 | 1.05–3.64 | 9 | 7 | 1.36 | 0.71–2.62 |
Other and ill-defined sites | C76–C80 | 138 | 130 | 1.06 | 0.90–1.25 | 173 | 147 | 1.18 | 1.01–1.37 |
Non-Hodgkin lymphoma | C81 | 5 | 6 | 0.78 | 0.32–1.87 | 7 | 8 | 0.84 | 0.40–1.77 |
Hodgkin lymphoma | C82–C85 | 72 | 82 | 0.87 | 0.69–1.10 | 145 | 130 | 1.12 | 0.95–1.31 |
Myeloma | C90 | 40 | 40 | 0.99 | 0.73–1.35 | 55 | 75 | 0.74 | 0.57–0.96 |
Leukaemia | C91–C95 | 123 | 127 | 0.97 | 0.81–1.16 | 126 | 155 | 0.81 | 0.68–0.97 |
Other and unspecified malignant neoplasms of lymphoid, haematopoietic and related tissue | C88, C96 | 1 | 4 | 0.26 | 0.04–1.87 | 1 | 4 | 0.25 | 0.04–1.80 |
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Linkeviciute-Ulinskiene, D.; Patasius, A.; Zabuliene, L.; Stukas, R.; Smailyte, G. Increased Risk of Site-Specific Cancer in People with Type 2 Diabetes: A National Cohort Study. Int. J. Environ. Res. Public Health 2020, 17, 246. https://doi.org/10.3390/ijerph17010246
Linkeviciute-Ulinskiene D, Patasius A, Zabuliene L, Stukas R, Smailyte G. Increased Risk of Site-Specific Cancer in People with Type 2 Diabetes: A National Cohort Study. International Journal of Environmental Research and Public Health. 2020; 17(1):246. https://doi.org/10.3390/ijerph17010246
Chicago/Turabian StyleLinkeviciute-Ulinskiene, Donata, Ausvydas Patasius, Lina Zabuliene, Rimantas Stukas, and Giedre Smailyte. 2020. "Increased Risk of Site-Specific Cancer in People with Type 2 Diabetes: A National Cohort Study" International Journal of Environmental Research and Public Health 17, no. 1: 246. https://doi.org/10.3390/ijerph17010246