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Malignancy risk in diabetes; a population study based on electronic health records

Year 2024, Volume: 22 Issue: 3, 255 - 262
https://doi.org/10.20518/tjph.1475986

Abstract

Objective: To document the risk of the most common types of malignancies in people with diabetes compared to the people without diabetes.

Methods: The data source of this study is the national electronic health records system of Türkiye (e-Nabız). We analysed only the data of people over 14 years old in 2019. All the people with ICD-O-3 codes recorded for the first time in 2019 were accepted as new tumour cases. Tumours with /3 behaviour codes were accepted as malignant.

Results: We detected 6,775,054 (10.6%) people with diabetes and 57,167,598 people without diabetes in our database. There were 63,696 new malignant cases in the group with diabetes and 123,662 new malignant cases in the group without diabetes. The total number of malignant tumours was 187,358. All types of major tumours seem to have increased risk. Pancreas cancer has the highest OR (odds ratio), 4.02 (3.71-4.36, 95% confidence interval), and larynx cancer has the lowest OR, 1.29 (1.19-1.41). OR for the presence of any malignancy in a person with diabetes is 1.87 (1.85-1.89).

Conclusion: All major types of malignant tumours have an increased incidence in people with diabetes. The results confirm the presence of a relationship between diabetes and malignancy.

Ethical Statement

Approved by the Clinical Research Ethics Committee of the Medical Faculty of Akdeniz University

Supporting Institution

None

Project Number

None

Thanks

None

References

  • Kim DS, Scherer PE. Obesity, Diabetes, and Increased Cancer Progression. Diabetes Metab J. 2021 Nov;45(6):799-812.
  • Cebioglu M, Schild HH, Golubnitschaja O. Diabetes mellitus as a risk factor for cancer: Stress or viral etiology? Infect Dis-ord Drug Targets. 2008;8:76–87.
  • Vulichi SR, Runthala A, Begari N, Rupak K, Chunduri VR, Kapur S, Chippada AR, Sistla DSM. Type-2 diabetes mellitus-associated cancer risk: In pursuit of understanding the possible link. Diabetes Metab Syndr. 2022 Sep;16(9):102591.
  • Lv Z, Guo Y. Metformin and Its Benefits for Various Diseases. Front Endocrinol (Lausanne). 2020;11:191.
  • Blonde L, Umpierrez GE, Reddy SS, McGill JB, Berga SL, Bush M, et al. American Association of Clinical Endocrinology Clini-cal Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract. 2022 Oct;28(10):923-1049.
  • Peila R, Rohan TE. Diabetes, Glycated Hemoglobin, and Risk of Cancer in the UK Biobank Study. Cancer Epidemiol Bi-omarkers Prev. 2020 Jun;29(6):1107-1119
  • Suh S, Kim KW. Diabetes and Cancer: Cancer Should Be Screened in Routine Diabetes Assessment. Diabetes Metab J. 2019 Dec;43(6):733-743.
  • Ramos-Garcia P, Roca-Rodriguez MDM, Aguilar-Diosdado M, Gonzalez-Moles MA. Diabetes mellitus and oral cancer/oral potentially malignant disorders: A systematic review and meta-analysis. Oral Dis. 2021;27:404-421.
  • Yan P, Wang Y, Yu X, Liu Y, Zhang ZJ. Type 2 diabetes mellitus and risk of head and neck cancer subtypes: a systematic re-view and meta-analysis of observational studies. Acta Diabetol. 2021;58:549-565.
  • Bae JM. Diabetes History and Gastric Cancer Risk: Different Results by Types of Follow-Up Studies. Asian Pac J Cancer Prev. 2022 May 1;23(5):1523-1528.
  • Jiang Y, Ben Q, Shen H, Lu W, Zhang Y, Zhu J. Diabetes mellitus and incidence and mortality of colorectal cancer: a system-atic review and meta-analysis of cohort studies. Eur J Epidemiol. 2011;26:863-876.
  • Wang P, Kang D, Cao W, Wang Y, Liu Z. Diabetes mellitus and risk of hepatocellular carcinoma: a systematic review and meta-analysis. Diabetes Metab Res Rev. 2012;28:109-122.
  • Ben Q, Xu M, Ning X, et al. Diabetes mellitus and risk of pancreatic cancer: A meta-analysis of cohort studies. Eur J Can-cer. 2011;47:1928-1937. Yi ZH, Luther Y, Xiong GH, et al. Association between diabetes mellitus and lung cancer: Meta-analysis. Eur J Clin Invest. 2020;50:e13332.
  • Qi L, Qi X, Xiong H, et al. Type 2 diabetes mellitus and risk of malignant melanoma: a systematic review and meta-analysis of cohort studies. Iran J Public Health. 2014;43:857-866
  • Lu Y, Hajjar A, Cryns VL, Trentham-Dietz A, Gangnon RE, Heckman-Stoddard BM, Alagoz O. Breast cancer risk for women with diabetes and the impact of metformin: A meta-analysis. Cancer Med. 2023 May;12(10):11703
  • Saed L, Varse F, Baradaran HR, Moradi Y, Khateri S, Friberg E, et al. The effect of diabetes on the risk of endometrial Can-cer: an updated a systematic review and meta-analysis. BMC Cancer. 2019 May 31;19(1):527.
  • Wang L, Zhong L, Xu B, Chen M, Huang H. Diabetes mellitus and the risk of ovarian cancer: a systematic review and meta-analysis of cohort and case-control studies. BMJ Open. 2020 Dec 29;10(12):e040137.
  • Bao C, Yang X, Xu W, et al. Diabetes mellitus and incidence and mortality of kidney cancer: a meta-analysis. J Diabetes Complications. 2013;27:357-364.
  • Zhu Z, Wang X, Shen Z et al. Risk of bladder cancer in patients with diabetes mellitus: an updated meta-analysis of 36 ob-servational studies. BMC Cancer. 2013;13:310.
  • Li H, Qian J. Association of diabetes mellitus with thyroid cancer risk: A meta-analysis of cohort studies. Medicine (Balti-more). 2017;96:e8230.
  • Castillo JJ, Mull N, Reagan JL, Nemr S, Mitri J. Increased incidence of non-Hodgkin lymphoma, leukemia, and myeloma in patients with diabetes mellitus type 2: a meta-analysis of observational studies. Blood. 2012;119:4845-4850.
  • Wang Y, Liu X, Yan P, Bi Y, Liu Y, Zhang ZJ. Association between type 1 and type 2 diabetes and risk of non-Hodgkin’s lym-phoma: A meta-analysis of cohort studies. Diabetes Metab. 2020;46:8-19.
  • Ohkuma T, Peters SAE, Woodward M. Sex differences in the association between diabetes and cancer: a systematic re-view and meta-analysis of 121 cohorts including 20 million individuals and one million events. Diabetologia 61, 2140–2154 (2018).
  • Tolunay T, Kaygusuz S, Keskinkılıç B, Özsarı S, Gökler ME. Türkiye Kanser İstatistikleri 2018. Ankara, Halk Sağlığı Genel Müdürlüğü (General Directorate of Public Health);2022, Ankara. https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/Dokumanlar/Istatistikler/Kanser_Rapor_2018.pdf
  • Yilmaz Kavcar SR, Acikgoz A, Ergor G, Unal B. Evaluating the Relationship between Diabetes and Cancer in a Cohort. Asian Pac J Cancer Prev. 2022;23:1223–1229.
  • Bailey CJ. Metformin: historical overview. Diabetologia. 2017;60:1566-1576.
  • Morris JA, Gardner MJ. Calculating confidence intervals for relative risks (odds ratios) and standardised ratios and rates. Br Med J (Clin Res Ed). 1988;296:1313-1316.
  • Zhang JJ, Jia JP, Shao Q, Wang YK. Diabetes mellitus and risk of pancreatic cancer in China: A meta-analysis based on 26 case-control studies. Prim Care Diabetes. 2019;13:276-282. Gang PJ, Mo L, Lu Y, Runqi L, Xing Z. Diabetes mellitus and the risk of prostate cancer: an update and cumulative meta-analysis. Endocrine Research. 2015;40:54-61.
Year 2024, Volume: 22 Issue: 3, 255 - 262
https://doi.org/10.20518/tjph.1475986

Abstract

Project Number

None

References

  • Kim DS, Scherer PE. Obesity, Diabetes, and Increased Cancer Progression. Diabetes Metab J. 2021 Nov;45(6):799-812.
  • Cebioglu M, Schild HH, Golubnitschaja O. Diabetes mellitus as a risk factor for cancer: Stress or viral etiology? Infect Dis-ord Drug Targets. 2008;8:76–87.
  • Vulichi SR, Runthala A, Begari N, Rupak K, Chunduri VR, Kapur S, Chippada AR, Sistla DSM. Type-2 diabetes mellitus-associated cancer risk: In pursuit of understanding the possible link. Diabetes Metab Syndr. 2022 Sep;16(9):102591.
  • Lv Z, Guo Y. Metformin and Its Benefits for Various Diseases. Front Endocrinol (Lausanne). 2020;11:191.
  • Blonde L, Umpierrez GE, Reddy SS, McGill JB, Berga SL, Bush M, et al. American Association of Clinical Endocrinology Clini-cal Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract. 2022 Oct;28(10):923-1049.
  • Peila R, Rohan TE. Diabetes, Glycated Hemoglobin, and Risk of Cancer in the UK Biobank Study. Cancer Epidemiol Bi-omarkers Prev. 2020 Jun;29(6):1107-1119
  • Suh S, Kim KW. Diabetes and Cancer: Cancer Should Be Screened in Routine Diabetes Assessment. Diabetes Metab J. 2019 Dec;43(6):733-743.
  • Ramos-Garcia P, Roca-Rodriguez MDM, Aguilar-Diosdado M, Gonzalez-Moles MA. Diabetes mellitus and oral cancer/oral potentially malignant disorders: A systematic review and meta-analysis. Oral Dis. 2021;27:404-421.
  • Yan P, Wang Y, Yu X, Liu Y, Zhang ZJ. Type 2 diabetes mellitus and risk of head and neck cancer subtypes: a systematic re-view and meta-analysis of observational studies. Acta Diabetol. 2021;58:549-565.
  • Bae JM. Diabetes History and Gastric Cancer Risk: Different Results by Types of Follow-Up Studies. Asian Pac J Cancer Prev. 2022 May 1;23(5):1523-1528.
  • Jiang Y, Ben Q, Shen H, Lu W, Zhang Y, Zhu J. Diabetes mellitus and incidence and mortality of colorectal cancer: a system-atic review and meta-analysis of cohort studies. Eur J Epidemiol. 2011;26:863-876.
  • Wang P, Kang D, Cao W, Wang Y, Liu Z. Diabetes mellitus and risk of hepatocellular carcinoma: a systematic review and meta-analysis. Diabetes Metab Res Rev. 2012;28:109-122.
  • Ben Q, Xu M, Ning X, et al. Diabetes mellitus and risk of pancreatic cancer: A meta-analysis of cohort studies. Eur J Can-cer. 2011;47:1928-1937. Yi ZH, Luther Y, Xiong GH, et al. Association between diabetes mellitus and lung cancer: Meta-analysis. Eur J Clin Invest. 2020;50:e13332.
  • Qi L, Qi X, Xiong H, et al. Type 2 diabetes mellitus and risk of malignant melanoma: a systematic review and meta-analysis of cohort studies. Iran J Public Health. 2014;43:857-866
  • Lu Y, Hajjar A, Cryns VL, Trentham-Dietz A, Gangnon RE, Heckman-Stoddard BM, Alagoz O. Breast cancer risk for women with diabetes and the impact of metformin: A meta-analysis. Cancer Med. 2023 May;12(10):11703
  • Saed L, Varse F, Baradaran HR, Moradi Y, Khateri S, Friberg E, et al. The effect of diabetes on the risk of endometrial Can-cer: an updated a systematic review and meta-analysis. BMC Cancer. 2019 May 31;19(1):527.
  • Wang L, Zhong L, Xu B, Chen M, Huang H. Diabetes mellitus and the risk of ovarian cancer: a systematic review and meta-analysis of cohort and case-control studies. BMJ Open. 2020 Dec 29;10(12):e040137.
  • Bao C, Yang X, Xu W, et al. Diabetes mellitus and incidence and mortality of kidney cancer: a meta-analysis. J Diabetes Complications. 2013;27:357-364.
  • Zhu Z, Wang X, Shen Z et al. Risk of bladder cancer in patients with diabetes mellitus: an updated meta-analysis of 36 ob-servational studies. BMC Cancer. 2013;13:310.
  • Li H, Qian J. Association of diabetes mellitus with thyroid cancer risk: A meta-analysis of cohort studies. Medicine (Balti-more). 2017;96:e8230.
  • Castillo JJ, Mull N, Reagan JL, Nemr S, Mitri J. Increased incidence of non-Hodgkin lymphoma, leukemia, and myeloma in patients with diabetes mellitus type 2: a meta-analysis of observational studies. Blood. 2012;119:4845-4850.
  • Wang Y, Liu X, Yan P, Bi Y, Liu Y, Zhang ZJ. Association between type 1 and type 2 diabetes and risk of non-Hodgkin’s lym-phoma: A meta-analysis of cohort studies. Diabetes Metab. 2020;46:8-19.
  • Ohkuma T, Peters SAE, Woodward M. Sex differences in the association between diabetes and cancer: a systematic re-view and meta-analysis of 121 cohorts including 20 million individuals and one million events. Diabetologia 61, 2140–2154 (2018).
  • Tolunay T, Kaygusuz S, Keskinkılıç B, Özsarı S, Gökler ME. Türkiye Kanser İstatistikleri 2018. Ankara, Halk Sağlığı Genel Müdürlüğü (General Directorate of Public Health);2022, Ankara. https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/Dokumanlar/Istatistikler/Kanser_Rapor_2018.pdf
  • Yilmaz Kavcar SR, Acikgoz A, Ergor G, Unal B. Evaluating the Relationship between Diabetes and Cancer in a Cohort. Asian Pac J Cancer Prev. 2022;23:1223–1229.
  • Bailey CJ. Metformin: historical overview. Diabetologia. 2017;60:1566-1576.
  • Morris JA, Gardner MJ. Calculating confidence intervals for relative risks (odds ratios) and standardised ratios and rates. Br Med J (Clin Res Ed). 1988;296:1313-1316.
  • Zhang JJ, Jia JP, Shao Q, Wang YK. Diabetes mellitus and risk of pancreatic cancer in China: A meta-analysis based on 26 case-control studies. Prim Care Diabetes. 2019;13:276-282. Gang PJ, Mo L, Lu Y, Runqi L, Xing Z. Diabetes mellitus and the risk of prostate cancer: an update and cumulative meta-analysis. Endocrine Research. 2015;40:54-61.
There are 28 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Original Research
Authors

Mustafa Mahir Ülgü 0000-0003-0825-1851

Mestan Emek 0000-0001-6843-4954

Mustafa Kemal Balcı 0000-0002-6494-3249

Kemal Hakan Gülkesen 0000-0002-2477-2481

Project Number None
Early Pub Date December 8, 2024
Publication Date
Submission Date May 20, 2024
Acceptance Date November 14, 2024
Published in Issue Year 2024 Volume: 22 Issue: 3

Cite

APA Ülgü, M. M., Emek, M., Balcı, M. K., Gülkesen, K. H. (2024). Malignancy risk in diabetes; a population study based on electronic health records. Turkish Journal of Public Health, 22(3), 255-262. https://doi.org/10.20518/tjph.1475986
AMA Ülgü MM, Emek M, Balcı MK, Gülkesen KH. Malignancy risk in diabetes; a population study based on electronic health records. TJPH. December 2024;22(3):255-262. doi:10.20518/tjph.1475986
Chicago Ülgü, Mustafa Mahir, Mestan Emek, Mustafa Kemal Balcı, and Kemal Hakan Gülkesen. “Malignancy Risk in Diabetes; A Population Study Based on Electronic Health Records”. Turkish Journal of Public Health 22, no. 3 (December 2024): 255-62. https://doi.org/10.20518/tjph.1475986.
EndNote Ülgü MM, Emek M, Balcı MK, Gülkesen KH (December 1, 2024) Malignancy risk in diabetes; a population study based on electronic health records. Turkish Journal of Public Health 22 3 255–262.
IEEE M. M. Ülgü, M. Emek, M. K. Balcı, and K. H. Gülkesen, “Malignancy risk in diabetes; a population study based on electronic health records”, TJPH, vol. 22, no. 3, pp. 255–262, 2024, doi: 10.20518/tjph.1475986.
ISNAD Ülgü, Mustafa Mahir et al. “Malignancy Risk in Diabetes; A Population Study Based on Electronic Health Records”. Turkish Journal of Public Health 22/3 (December 2024), 255-262. https://doi.org/10.20518/tjph.1475986.
JAMA Ülgü MM, Emek M, Balcı MK, Gülkesen KH. Malignancy risk in diabetes; a population study based on electronic health records. TJPH. 2024;22:255–262.
MLA Ülgü, Mustafa Mahir et al. “Malignancy Risk in Diabetes; A Population Study Based on Electronic Health Records”. Turkish Journal of Public Health, vol. 22, no. 3, 2024, pp. 255-62, doi:10.20518/tjph.1475986.
Vancouver Ülgü MM, Emek M, Balcı MK, Gülkesen KH. Malignancy risk in diabetes; a population study based on electronic health records. TJPH. 2024;22(3):255-62.

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