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Cancer risk in Chinese diabetes patients: a retrospective cohort study based on management data

The excess risk of cancer observed in patients with type 2 diabetes (T2DM) may have been influenced by detection bias. The aim of this study was to examine the real association by evaluating time-varying site-specific cancer risks in newly diagnosed T2DM patients. A total of 51,324 registered cancer...

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Autores principales: Fang, Yuan, Zhang, Xuehong, Xu, Huilin, Smith-Warner, Stephanie A, Xu, Dongli, Fang, Hong, Xu, Wang Hong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bioscientifica Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300864/
https://www.ncbi.nlm.nih.gov/pubmed/30475218
http://dx.doi.org/10.1530/EC-18-0381
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author Fang, Yuan
Zhang, Xuehong
Xu, Huilin
Smith-Warner, Stephanie A
Xu, Dongli
Fang, Hong
Xu, Wang Hong
author_facet Fang, Yuan
Zhang, Xuehong
Xu, Huilin
Smith-Warner, Stephanie A
Xu, Dongli
Fang, Hong
Xu, Wang Hong
author_sort Fang, Yuan
collection PubMed
description The excess risk of cancer observed in patients with type 2 diabetes (T2DM) may have been influenced by detection bias. The aim of this study was to examine the real association by evaluating time-varying site-specific cancer risks in newly diagnosed T2DM patients. A total of 51,324 registered cancer-free individuals newly diagnosed with T2DM between 2004 and 2014 were linked with the Shanghai Cancer Registry and the Vital Statistics through September 2015. A total of 2920 primary, invasive cancer cases were identified during 325,354 person-years period. Within 1 year following diabetes onset, participants with T2DM had higher risks of total, lung and rectal cancer in men and total, liver, pancreas, thyroid, breast and uteri cancer in women. Thereafter the incidence for overall cancer decreased and then increased along with follow-up time, with the upward trend varying by cancer, suggesting potential detection bias. After the initial 1-year period, standardized incidence ratios (SIR) and 95% CIs for overall cancer were 0.80 (95% CI 0.76–0.85) in men and 0.93 (95% CI 0.88–0.99) in women, but a higher risk of breast and thyroid cancers were observed in women, with SIR and 95% CI being 1.13 (1.01, 1.28) and 1.37 (1.11, 1.63), respectively. Our results suggest that T2DM patients are at higher risk of certain cancers; this risk particularly increases shortly after diabetes diagnosis, which is likely to be due to detection bias caused by increased ascertainment. Prevention of female breast and thyroid cancers should be paid attention in Chinese individuals with T2DM.
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spelling pubmed-63008642018-12-26 Cancer risk in Chinese diabetes patients: a retrospective cohort study based on management data Fang, Yuan Zhang, Xuehong Xu, Huilin Smith-Warner, Stephanie A Xu, Dongli Fang, Hong Xu, Wang Hong Endocr Connect Research The excess risk of cancer observed in patients with type 2 diabetes (T2DM) may have been influenced by detection bias. The aim of this study was to examine the real association by evaluating time-varying site-specific cancer risks in newly diagnosed T2DM patients. A total of 51,324 registered cancer-free individuals newly diagnosed with T2DM between 2004 and 2014 were linked with the Shanghai Cancer Registry and the Vital Statistics through September 2015. A total of 2920 primary, invasive cancer cases were identified during 325,354 person-years period. Within 1 year following diabetes onset, participants with T2DM had higher risks of total, lung and rectal cancer in men and total, liver, pancreas, thyroid, breast and uteri cancer in women. Thereafter the incidence for overall cancer decreased and then increased along with follow-up time, with the upward trend varying by cancer, suggesting potential detection bias. After the initial 1-year period, standardized incidence ratios (SIR) and 95% CIs for overall cancer were 0.80 (95% CI 0.76–0.85) in men and 0.93 (95% CI 0.88–0.99) in women, but a higher risk of breast and thyroid cancers were observed in women, with SIR and 95% CI being 1.13 (1.01, 1.28) and 1.37 (1.11, 1.63), respectively. Our results suggest that T2DM patients are at higher risk of certain cancers; this risk particularly increases shortly after diabetes diagnosis, which is likely to be due to detection bias caused by increased ascertainment. Prevention of female breast and thyroid cancers should be paid attention in Chinese individuals with T2DM. Bioscientifica Ltd 2018-11-19 /pmc/articles/PMC6300864/ /pubmed/30475218 http://dx.doi.org/10.1530/EC-18-0381 Text en © 2018 The authors http://creativecommons.org/licenses/by-nc/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Research
Fang, Yuan
Zhang, Xuehong
Xu, Huilin
Smith-Warner, Stephanie A
Xu, Dongli
Fang, Hong
Xu, Wang Hong
Cancer risk in Chinese diabetes patients: a retrospective cohort study based on management data
title Cancer risk in Chinese diabetes patients: a retrospective cohort study based on management data
title_full Cancer risk in Chinese diabetes patients: a retrospective cohort study based on management data
title_fullStr Cancer risk in Chinese diabetes patients: a retrospective cohort study based on management data
title_full_unstemmed Cancer risk in Chinese diabetes patients: a retrospective cohort study based on management data
title_short Cancer risk in Chinese diabetes patients: a retrospective cohort study based on management data
title_sort cancer risk in chinese diabetes patients: a retrospective cohort study based on management data
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300864/
https://www.ncbi.nlm.nih.gov/pubmed/30475218
http://dx.doi.org/10.1530/EC-18-0381
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