Abstract
Several studies suggest that diabetes carries an increased risk for a number of different cancer types. The aim of this study was to investigate the incidence of 14 different cancer types in the diabetic and non-diabetic population. IMS Disease Analyzer™ (DA) database was used, focusing on patients with or without diabetes in general practice in France. The analysis was performed retrospectively from 2001 to 2013. The Hazard Ratios (HR; Cox regression) for the risk of cancer in diabetic versus non-diabetic patients were adjusted for demographic and clinical variables. IMS Oncology Analyzer™ (OA) database was also used to describe the cancer patient profile in 2013. Overall 3.1% of patients in DA are diabetic. 75,104 patients were diagnosed with type-2 Diabetes Mellitus (T2DM). This population was matched to a control group in terms of age (60±15 years) and gender (male: 52%). The overall risk of cancer was lower in T2DM patients than in patients without diabetes (HR: 0.81; CI: 0.76 to 0.85). Those patients were less likely to develop breast, prostate, lung cancer or non-hodgkin lymphoma. Nevertheless, their risk was significantly higher regarding liver cancer (HR: 1.99; CI: 1.46 to 2.72), pancreatic cancer (HR: 2.13; CI: 1.51 to 3.00) and endometrial cancer (HR: 1.25; CI: 1.01 to 1.55). No significant increase in risk was observed in colorectal, stomach, kidney, thyroid, urinary bladder, gall bladder and oesophageal cancer. OA showed a higher proportion of diabetic patients among the cancer population (14.6%, n=10,621). Consistently, this rate was even higher in patients diagnosed with pancreatic (28.7%, n=362), liver (27.0%, n=256) and endometrial cancer (21.7%, n=161). This retrospective analysis showed that T2DM may increase the risk of certain cancer types but seems to prevent from some others. Further research is required to evaluate the factors involving the diabetes-cancer correlations, such as the anti-diabetic drugs.
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