Abstract
Studies examining the relationship between diabetes mellitus (DM) and the risk of gastric cancer incidence or gastric cancer mortality have produced inconsistent results. The purpose of this study was to evaluate the evidence regarding the relationship between DM and subsequent gastric cancer incidence or gastric cancer mortality risk on the basis of cohort studies. A systematic search of articles in PubMed, EmBase, the Cochrane Library, and reference lists was conducted to identify relevant literature. Twenty-two cohort studies reporting data on 8,559,861 participants were included in the study. Overall, participants with DM had little or no change in the risk of gastric cancer, or gastric cancer mortality. There was no evidence of difference in the RR for gastric cancer between men and women. Participants with DM had a non-significant trend towards an increased risk of gastric cancer mortality in men. There was no significant difference between men and women for this relationship. Finally, although subgroup analysis suggested DM was associated with a significant impact on gastric cancer incidence and gastric cancer mortality risk in several specific populations, a significance based on gender difference was not observed. In conclusion, DM might increase the risk of gastric cancer in men when the study used standard incidence/mortality ratio as effect estimate. Further, DM were associated with higher risk of gastric cancer mortality in men if the mean age at baseline less than 55.0 years, used RR or HR as effect estimate, the study adjusted smoking or not, and the study not adjusted alcohol drinking.
Highlights
Diabetes mellitus (DM) is a growing global pandemic afflicting approximately three to four percent of adults worldwide
A total of 34 studies were reviewed in detail, and 4 without gastric cancer incidence or mortality outcomes were ruled out and another 8 studies were excluded as being different publications of the same sample of participants, thereby including main results that had already been reviewed [30,31,32,33,34,35,36,37]
Our current study was based on cohort studies and explored all possible correlations between DM and the outcomes of gastric cancer incidence and gastric cancer mortality
Summary
Diabetes mellitus (DM) is a growing global pandemic afflicting approximately three to four percent of adults worldwide. Epidemiologic studies examining the association between DM and gastric cancer risk have largely been inconclusive and provide conflicting results [15,16,17,18,19,20,21], including two meta-analyses of the relationship between DM and the risk of gastric cancer [22,23]. Whether these relationships differ according to gender in specific subpopulations remains controversial
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