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The temporal relationship between diabetes and cancer: A population‐based study
Author(s) -
Lega Iliana C.,
Wilton Andrew S.,
Austin Peter C.,
Fischer Hadas D.,
Johnson Jeffrey A.,
Lipscombe Lorraine L.
Publication year - 2016
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.30095
Subject(s) - medicine , diabetes mellitus , incidence (geometry) , hazard ratio , odds ratio , population , confidence interval , cancer , cohort study , retrospective cohort study , endocrinology , environmental health , optics , physics
BACKGROUND Diabetes is associated with an increased risk of several cancers; however, greater detection of cancer around the time of diabetes diagnosis may partly contribute to this relationship. The goal of the current study was to explore the temporal relationship between diabetes and cancer incidence. METHODS The authors conducted a retrospective, population‐based cohort study of >1 million adults living in Ontario, Canada to evaluate the association between diabetes diagnosis and the incidence of cancer in 3 time periods: within the 10 years before a diabetes diagnosis, within the first 3 months after a diabetes diagnosis, and from 3 months to 10 years after a diabetes diagnosis. RESULTS Individuals with diabetes were significantly more likely to have been diagnosed with cancer within the 10 years before a diabetes diagnosis compared with individuals without diabetes (odds ratio, 1.23; 95% confidence interval [95% CI], 1.19‐1.27). Cancer incidence also was found to be significantly higher in individuals with diabetes within the 3‐month period after a diabetes diagnosis (hazard ratio, 1.62; 95% CI, 1.52‐1.74), whereas the risk was not found to be elevated in the later period (hazard ratio, 0.97; 95% CI, 0.95‐0.98). Similar trends were noted for individual cancers. CONCLUSIONS The results demonstrated that individuals with diabetes had a significantly higher risk of most cancers, which was limited to the time periods before and immediately after a diabetes diagnosis. The highest risk period was observed within the first 3 months after a diabetes diagnosis, suggesting a partial role of detection bias in the apparent relationship between diabetes and cancer. Cancer 2016. © 2016 American Cancer Society . Cancer 2016;122:2731–2738. © 2016 American Cancer Society.