Association Between Diabetes and Cancer Risk: A Rapid Review of Cohort Studies Published Since 2013 to 2024.

Sinelile Phoseka; Ziningi Jaya; Nokukhanya Thembane

doi:10.51168/sjhrafrica.v6i3.1493

Authors

Miss Sinelile Phoseka Department of Biomedical Sciences, Faculty of Applied and Health Science, Mangosuthu University of Technology, South Africa, Durban.
Ziningi Jaya Department of Biomedical Sciences, Faculty of Applied and Health Science, Mangosuthu University of Technology, South Africa, Durban.
Ms Nokukhanya Thembane Department of Biomedical Sciences, Faculty of Applied and Health Science, Mangosuthu University of Technology, South Africa, Durban.

DOI:

https://doi.org/10.51168/sjhrafrica.v6i3.1493

Keywords:

Diabetes, Cancer risk, Obesity, Glycaemic contro, Diabetes treatment, Risk ratio

Abstract

Background

Diabetes mellitus (DM) and cancer are two prevalent and debilitating health conditions worldwide. Emerging evidence suggests that diabetes not only increases the risk of developing various cancers but may also worsen cancer progression and complicate treatment outcomes. This rapid review evaluates existing cohort studies that investigate the progression from diabetes to cancer, with a focus on identifying key factors that potentially influence cancer development in diabetic patients.

Methods

25 cohort studies from 2013-2024 sourced from Google Scholar, including prospective, retrospective, and clinical studies examining the relative risk of various cancers in diabetic populations were reviewed. The quantitative cancer risk analyses conducted on people with diabetes in these studies were also reviewed. Studies that did not report risk estimates and studies with cross-sectional or case-control designs were excluded.

Results

The review showed a gradual increase in the number of studies investigating the relationship between diabetes and cancer, with the highest proportion conducted between 2021 (16%) and 2023 (12%). Findings revealed an association of Type 2 DM (T2DM) with a higher risk of pancreatic cancer (OR = 2.50) and colorectal cancer in men (HR = 1.42). Standardized risk ratios (SRR) revealed stronger associations of T2DM with certain cancers, including endometrial cancer (SRR = 1.81).

Conclusion

When compared with Type 1 DM, T2DM is associated with a higher risk of cancer including pancreatic, colorectal, endometrial, and breast cancers. Obesity, glycaemic control, disease duration, and the effects of therapeutic treatment have been highlighted as factors that contribute to this increased risk. Furthermore, the study emphasizes the importance of tailored approaches to cancer risk management in diabetes patients, considering gender, region, and treatment techniques.

Recommendations

Future research should investigate the link between diabetes and cancer, emphasizing underexplored cancer types, diabetes medications, gender, region, and socioeconomic status to enhance cancer prevention in diabetic populations.

Author Biographies

Miss Sinelile Phoseka, Department of Biomedical Sciences, Faculty of Applied and Health Science, Mangosuthu University of Technology, South Africa, Durban.

is a Bachelor of Health Science in Medical Laboratory Science student, specializing in Clinical Pathology from Mangosuthu University of Technology. She has a strong work ethic and a passion for lifelong learning. She is committed to delivering high-quality work with integrity and efficiency. She is dedicated to making a positive impact in her community.

Ziningi Jaya, Department of Biomedical Sciences, Faculty of Applied and Health Science, Mangosuthu University of Technology, South Africa, Durban.

is a qualified Medical Technology, lecturing and supervising student research in the Department of Biomedical Science at Mangosuthu University of Technology. Her research focuses on investigating diverse healthcare interventions for infectious diseases mainly to respond to the diverse healthcare needs of people in surrounding communities.

ORCID: https://orcid.org/0000-0003-1053-5458

Ms Nokukhanya Thembane, Department of Biomedical Sciences, Faculty of Applied and Health Science, Mangosuthu University of Technology, South Africa, Durban.

is a Medical Laboratory Scientist/Technologist, Senior Lecturer, and Researcher at Mangosuthu University of Technology and the University of KwaZulu-Natal. She specializes in Clinical Pathology, with a focus on therapeutic drug monitoring and drug discovery. Her work involves teaching and supervising students and conducting research to contribute to advancements in patient care in disenfranchised communities and medical laboratory science.

ORCID: https://orcid.org/0000-0001-9146-3809

References

Alharmoodi, F., Al Ameri, M.A., Alblooshi, M., Shanbhag, N.M., Almheiri, M.H. and Sumaida, A.B., 2024. Exploring the Relationship Between Diabetes and Breast Cancer in the United Arab Emirates. Cureus, 16(2). DOI: 10.7759/cureus.54787 https://doi.org/10.7759/cureus.54787

Carstensen, B., Read, S.H., Friis, S., Sund, R., Keskimäki, I., Svensson, A.M., Ljung, R., Wild, S.H., Kerssens, J.J., Harding, J.L. and Magliano, D.J., 2016. Cancer incidence in persons with type 1 diabetes: a five-country study of 9,000 cancers in type 1 diabetic individuals. Diabetologia, 59, pp.980-988. https://doi.org/10.1007/s00125-016-3884-9 PMid:26924393 PMCid:PMC4826427

Chhikara, B.S. & Parang, K., 2023, 'Global Cancer Statistics 2022: the trends projection analysis', Chemical Biology Letters, 10(1), 451.

Conway, R.B., Hudson, A.G., Munro, H., Fu, D., McClain, D.A., and Blot, W.J., 2024. Diabetes and pancreatic cancer risk in a multiracial cohort. Diabetic Medicine, 41(4), p.e15234. https://doi.org/10.1111/dme.15234

https://doi.org/10.1111/dme.15234 PMid:37779225

Feng, X., Song, M., Preston, M.A., Ma, W., Hu, Y., Pernar, C.H., Stopsack, K.H., Ebot, E.M., Fu, B.C., Zhang, Y., Li, N., Dai, M., Liu, L., Giovannucci, E.L. & Mucci, L.A., 2020, 'The association of diabetes with risk of prostate cancer defined by clinical and molecular features', British Journal of Cancer, 123(4), 657-665. https://doi.org/10.1038/s41416-020-0910-y PMid:32467600 PMCid: PMC7435261

George, S., Jean-Baptiste, W., Yusuf Ali, A., Inyang, B., Koshy, F.S., George, K., Poudel, P., Chalasani, R., Goonathilake, M.R., Waqar, S. & Mohammed, L., 2022, 'The Role of Type 2 Diabetes in Pancreatic Cancer', Cureus. DOI: 10.7759/cureus.26288 https://doi.org/10.7759/cureus.26288

Hsu, P.C., Lin, W.H., Kuo, T.H., Lee, H.M., Kuo, C. & Li, C.Y., 2015a, 'A population-based cohort study of all-cause and site-specific cancer incidence among patients with type 1 diabetes mellitus in Taiwan', Journal of Epidemiology, 25(9), 567-573. https://doi.org/10.2188/jea.JE20140197 PMid:26212724 PMCid: PMC4549608

Jacobson, S., Dahlqvist, P., Johansson, M., Svensson, J., Billing, O., Sund, M. and Franklin, O., 2021. Hyperglycemia as a risk factor in pancreatic cancer: A nested case-control study using prediagnostic blood glucose levels. Pancreatology, 21(6), pp.1112-1118. https://doi.org/10.1016/j.pan.2021.05.008 PMid:34049822

Jensen, B.W., Watson, C., Geifman, N., Baker, J.L., Badrick, E. & Renehan, A.G., 2022, 'Weight Changes in Type 2 Diabetes and Cancer Risk: A Latent Class Trajectory Model Study', Obesity Facts, 15(2), 150-159.https://doi.org/10.1159/000520200 PMid:34903697 PMCid:PMC9021620

Lam, B.Q., Srivastava, R., Morvant, J., Shankar, S. & Srivastava, R.K., 2021, Association of diabetes mellitus and alcohol abuse with cancer: Molecular mechanisms and clinical significance, Cells, 10(11). https://doi.org/10.3390/cells10113077 PMid:34831299 PMCid: PMC8620339

Larsson, S.C., Giovannucci, E.L. & Wolk, A., 2016, Sweetened Beverage Consumption and Risk of Biliary Tract and Gallbladder Cancer in a Prospective Study, Journal of the National Cancer Institute, 108(10). https://doi.org/10.1093/jnci/djw125 PMid:27281756

Ling, S., Brown, K., Miksza, J.K., Howells, L., Morrison, A., Issa, E., Yates, T., Khunti, K., Davies, M.J. and Zaccardi, F., 2020. Association of type 2 diabetes with cancer: a meta-analysis with bias analysis for unmeasured confounding in 151 cohorts comprising 32 million people. Diabetes care, 43(9), pp.2313-2322.

https://doi.org/10.2337/dc20-0204 PMid:32910779

Ma, Y., Yang, W., Song, M., Smith-Warner, S.A., Yang, J., Li, Y., Ma, W., Hu, Y., Ogino, S., Hu, F.B. and Wen, D., 2018. Type 2 diabetes and risk of colorectal cancer in two large US prospective cohorts. British Journal of Cancer, 119(11), pp.1436-1442. https://doi.org/10.1038/s41416-018-0314-4 PMid:30401889 PMCid: PMC6265303

Ma, R.C.W., So, W.Y., Tam, C.H.T., Luk, A.O., Ho, J.S.K., Wang, Y., Lam, V.K., Lee, H.M., Kong, A.P., Tong, P.C. and Xu, G., 2014. Genetic variants for type 2 diabetes and new-onset cancer in Chinese with type 2 diabetes. Diabetes Research and Clinical Practice, 103(2), pp.328-337. https://doi.org/10.1016/j.diabres.2013.12.016 PMid:24468095

Mao, D., Lau, E.S., Wu, H., Yang, A., Shi, M., Fan, B., Tam, C.H., Chow, E., Kong, A.P., Ma, R.C. and Luk, A., 2022. Risk associations of long-term HbA1c variability and obesity on cancer events and cancer-specific death in 15,286 patients with diabetes-A prospective cohort study. The Lancet Regional Health-Western Pacific, 18. https://doi.org/10.1016/j.lanwpc.2021.100315 PMid:35024653 PMCid: PMC8669375

Marcovecchio, M.L., 2017, Complications of acute and chronic hyperglycemia, US Endocrinology, 13(1), 17-21. https://doi.org/10.17925/USE.2017.13.01.17

Parsons, K., 2023. The association between pre-existing type 2 diabetes on breast cancer-related and all-cause mortality among women with breast cancer. McGill University (Canada).

Paternoster, S. & Falasca, M., 2020, 'The intricate relationship between diabetes, obesity, and pancreatic cancer', Biochimica et Biophysica Acta (BBA) - Reviews on Cancer, 1873(1), 188326. https://doi.org/10.1016/j.bbcan.2019.188326 PMid:31707038

Patil, S.R., Chavan, A.B., Patel, A.M., Chavan, P.D. & Bhopale, J.V., 2023, 'A Review on Diabetes Mellitus its Types, Pathophysiology, Epidemiology and its Global Burden', Journal for Research in Applied Sciences and Biotechnology, 2(4), 73-79. https://doi.org/10.55544/jrasb.2.4.9

Pearson-Stuttard, J., Papadimitriou, N., Markozannes, G., Cividini, S., Kakourou, A., Gill, D., Rizos, E.C., Monori, G., Ward, H.A., Kyrgiou, M. and Gunter, M.J., 2021. Type 2 diabetes and cancer: an umbrella review of observational and Mendelian randomization studies. Cancer Epidemiology, Biomarkers & Prevention, 30(6), pp.1218-1228. https://doi.org/10.1158/1055-9965.EPI-20-1245 PMid:33737302 PMCid: PMC9398112

Roy, A., Sahoo, J., Kamalanathan, S., Naik, D., Mohan, P. and Kalayarasan, R., 2021. Diabetes and pancreatic cancer: Exploring the two-way traffic. World Journal of Gastroenterology, 27(30), p.4939. https://doi.org/10.3748/wjg.v27.i30.4939 PMid:34497428 PMCid: PMC8384733

Shlomai, G., Neel, B., LeRoith, D. and Gallagher, E.J., 2016. Type 2 diabetes mellitus and cancer: the role of pharmacotherapy. Journal of Clinical Oncology, 34(35), pp.4261-4269.https://doi.org/10.1200/JCO.2016.67.4044 PMid:27903154 PMCid: PMC5455318

Stan, M.C., Mireştean, C.C., Stoica, D., Popescu, F.C. & Bădulescu, F., 2023, 'Lung cancer and type 2 diabetes experience in Dolj County (southwest region of Romania) - a clinical, bioclinical and pathological study', Romanian Journal of Morphology and Embryology, 64(3), 411-417. https://doi.org/10.47162/RJME.64.3.12

PMid:37867358 PMCid: PMC10720928

Tang, Z., Xu, W. and Zhang, M., 2022. Association between type 2 diabetes and 5-year overall survival in early-stage pancreatic cancer: a retrospective cohort study. PeerJ, 10, p.e14538. https://doi.org/10.7717/peerj.14538 PMid:36530401 PMCid: PMC9753753

Tsilidis, K.K., Kasimis, J.C., Lopez, D.S., Ntzani, E.E. and Ioannidis, J.P., 2015. Type 2 diabetes and cancer: umbrella review of meta-analyses of observational studies. Bmj, 350.https://doi.org/10.1136/bmj.g7607 PMid:25555821

Urpilainen, E., Marttila, M., Hautakoski, A., Arffman, M., Sund, R., Ilanne-Parikka, P., Arima, R., Kangaskokko, J., Puistola, U., Hinkula, M. and Läärä, E., 2018. Prognosis of ovarian cancer in women with type 2 diabetes using metformin and other forms of antidiabetic medication or statins: a retrospective cohort study. BMC Cancer, 18, pp.1-9.https://doi.org/10.1186/s12885-018-4676-z PMid:30055585 PMCid:PMC6064082

Wang, Y., Liu, X., Yan, P., Bi, Y., Liu, Y., and Zhang, Z.J., 2020. Association between type 1 and type 2 diabetes and risk of non-Hodgkin's lymphoma: a meta-analysis of cohort studies. Diabetes & Metabolism, 46(1), pp.8-19. https://doi.org/10.1016/j.diabet.2019.04.006 PMid:31039401

Wu, H., Lau, E.S., Yang, A., Zhang, X., Fan, B., Ma, R.C., Kong, A.P., Chow, E., Chan, J.C. and Luk, A., 2022. 1208-P: Age-Specific Association between Risk Factors and All-Cause and Cause-Specific Mortality in People with Type 2 Diabetes. Diabetes, 71(Supplement_1). https://doi.org/10.2337/db22-1208-P

Yu, X., Fu, B., Sun, T. and Sun, X., 2024. The causal relationship between diabetes mellitus and lung cancer: two-sample Mendelian randomization and mediation analysis. Frontiers in Genetics, 15, p.1449881.

https://doi.org/10.3389/fgene.2024.1449881 PMid:39655224 PMCid: PMC11625780

Zhang, Z.-H., Su, P.-Y., Hao, J.-H. & Sun, Y.-H., 2013, 'The Role of Preexisting Diabetes Mellitus on Incidence and Mortality of Endometrial Cancer: A Meta-Analysis of Prospective Cohort Studies', International Journal of Gynecologic Cancer, 23(2), 294. https://doi.org/10.1097/IGC.0b013e31827b8430 PMid:23287960