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Senior Citizen Health & Medicine
Diabetes Linked to Increased Cancer Risk
Risk for men 27% higher and 21% higher for women in
Japan
September 25, 2006 - Adults with diabetes, which
includes 20 percent of America's senior citizens, may have
a higher risk of cancer overall and in several specific organs,
including the liver, pancreas and kidney, according to results of a
large study in Japan published in the September 25 issue of Archives of
Internal Medicine, one of the JAMA/Archives journals.
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Health & Medicine |
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More than one out of five senior citizens has
diabetes and almost 40 percent of seniors have pre-diabetes. In rough
numbers, this is about 23 million people age 65 and older with the
disease or in danger of developing it.
Researchers have long suspected that there might be
an association between diabetes and cancer, but no conclusive evidence
has been obtained, according to background information in the article.
Diabetes is rapidly becoming more common in Japan, as it is in many
other countries.
More than 7.4 million Japanese individuals were
estimated to have diabetes in 2002, and by 2025, 8.7 percent of the
population is expected to develop the disease. Clarification of the
association between diabetes mellitus and cancer in populations with an
increasing prevalence, such as Japanese persons, is a crucial task, not
only from the causative point of view but also with regard to the
formulation of clinical strategies and public health policies for the
target population, the authors write.
Manami Inoue, M.D., Ph.D., National Cancer Center,
Tokyo, and colleagues studied the association in 97,771 Japanese
individuals (46,548 men and 51,223 women) age 40 to 69 who were enrolled
in the study between 1990 and 1994.
The participants, who had an average age of 51 at
the beginning of the study, completed a lifestyle questionnaire at that
time that included information about smoking, alcohol drinking, medical
history, physical activity and food and beverage intake. They were also
asked if they had ever been diagnosed with diabetes or taken diabetes
medications. Researchers consulted the national registry of Japanese
residents, major hospitals, cancer registries and death certificates to
track deaths and cancer cases.
At the beginning of the study, 3,097 men (6.7
percent) and 1,571 women (3.1 percent) had a history of diabetes. By the
end of the studys follow-up in 2003, 6,462 participants had developed
cancer, including 3,907 men (366 of whom had diabetes) and 2,555 women
(104 with diabetes).
Men with diabetes had a 27 percent higher risk of
developing cancer than men without diabetes; the risk was especially
high for liver, kidney and pancreatic cancer.
Among women, those with diabetes had a 21 percent
higher risk of cancer than those without (although this increased risk
was not statistically significant). However, there was a significantly
higher risk for stomach and liver cancer and a borderline higher risk
for ovarian cancer.
It is unclear exactly how diabetes might contribute
to cancer; many discussions of the issue have focused on the particular
type of cancer, such as liver or pancreatic cancer, the authors write.
Researchers suspect that excess insulin in diabetic patients may promote
growth in the cells of these organs, increasing cancer risk.
In addition, changes in sex hormone levels
associated with diabetes could contribute to ovarian cancer in women and
prostate cancer in men. Despite the biological plausibility of the
association, several issues should be considered when discussing the
role of diabetes mellitus as a cause of cancer, the authors warn.
For example, common health conditions and risk
factors such as obesity might contribute to both diabetes and cancer,
and some types of cancer may actually cause diabetes.
In addition, those being treated for diabetes often
visit a physician more frequently than those without a chronic health
condition, and this increased vigilance could lead to more cancer
diagnoses. These issues should likely be considered as alternative
factors affecting the association between diabetes mellitus and cancer,
directly or otherwise.
Regardless of whether diabetes causes cancer,
cancer causes diabetes or a common third cause links them both, it is
likely that the rapidly increasing incidence of diabetes among Japanese
residents in recent years heralds a future increase in cases of cancer,
especially those kinds most closely linked with diabetes, they conclude.
Editor's Note: This study was supported by a
Grant-in-Aid for Cancer Research and for the Third Term Comprehensive
Control Research for Cancer from the Ministry of Health, Labour and
Welfare, Japan.
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