Prediabetes and the risk of cancer: a meta-analysis

• Published in: Diabetologia Vol. 57; no. 11; pp. 2261 - 2269
• Main Authors: Huang, Yi, Cai, Xiaoyan, Qiu, Miaozhen, Chen, Peisong, Tang, Hongfeng, Hu, Yunzhao, Huang, Yuli
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2014; Springer; Springer Nature B.V
• Subjects: Biological and medical sciences; Cohort analysis; Colorectal cancer; Diabetes; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Epidemiology; Ethnicity; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fasting; Female; Glucose; Human Physiology; Humans; Internal Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Meta-Analysis; Metabolic Diseases; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasms - epidemiology; Neoplasms - etiology; Oncology; Prediabetic State - complications; Prediabetic State - epidemiology; Prospective Studies; Risk Factors; Tumors; China; Impaired fasting glucose; Prediabetes; Impaired glucose tolerance; Risk factors; Cancer; Endocrinopathy; Fasting; Diabetes mellitus; Risk factor; Glucose; Malignant tumor
• ISSN: 0012-186X; 1432-0428; 1432-0428
• DOI: 10.1007/s00125-014-3361-2

Aims/hypothesis The results from prospective cohort studies of prediabetes (impaired fasting glucose and/or impaired glucose tolerance) and risk of cancer are controversial. We conducted a meta-analysis to evaluate the risk of cancer in association with impaired fasting glucose and impaired glucose tolerance. Methods The PubMed, EMBASE and Cochrane Library databases were searched for prospective cohort studies with data on prediabetes and cancer. Two independent reviewers assessed the reports and extracted the data. Prospective studies were included if they reported adjusted RRs with 95% CIs for the association between cancer and prediabetes. Subgroup analyses were conducted according to endpoint, age, sex, ethnicity, duration of follow-up and study characteristics. Results Data from 891,426 participants were derived from 16 prospective cohort studies. Prediabetes was associated with an increased risk of cancer overall (RR 1.15; 95% CI 1.06, 1.23). The results were consistent across cancer endpoint, age, duration of follow-up and ethnicity. There was no significant difference for the risk of cancer with different definitions of prediabetes. In a site-specific cancer analysis, prediabetes was significantly associated with increased risks of cancer of the stomach/colorectum, liver, pancreas, breast and endometrium (all p  < 0.05), but not associated with cancer of the bronchus/lung, prostate, ovary, kidney or bladder. The risks of site-specific cancer were significantly different ( p  = 0.01) and were highest for liver, endometrial and stomach/colorectal cancer. Conclusions/interpretation Overall, prediabetes was associated with an increased risk of cancer, especially liver, endometrial and stomach/colorectal cancer.