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Am J Epidemiol 2004; 159:1160-1167.
Copyright © 2004 by the Johns Hopkins Bloomberg School of Public Health


ORIGINAL CONTRIBUTIONS

Diabetes Mellitus as a Predictor of Cancer Mortality in a Large Cohort of US Adults

Steven S. Coughlin1 , Eugenia E. Calle2, Lauren R. Teras2, Jennifer Petrelli2 and Michael J. Thun2

1 Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
2 Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA.

Several studies have suggested that diabetes mellitus may alter the risk of developing a variety of cancers, and the associations are biologically plausible. To learn more about the relation between diabetes and cancer mortality, the authors examined associations with selected cancers in a large, prospective US cohort of 467,922 men and 588,321 women who had no reported history of cancer at enrollment in 1982. After 16 years of mortality follow-up, diabetes was significantly associated with fatal colon cancer in men (multivariate relative risk (RR) = 1.20, 95% confidence interval (CI): 1.06, 1.37) and women (RR = 1.24, 95% CI: 1.07, 1.43) and with pancreatic cancer in men (RR = 1.48, 95% CI: 1.27, 1.73) and women (RR = 1.44, 95% CI: 1.21, 1.72). For men, diabetes was significantly associated with liver cancer (RR = 2.19, 95% CI: 1.76, 2.72) and bladder cancer (RR = 1.43, 95% CI: 1.14, 1.80). In addition, diabetes was significantly associated with breast cancer in women (RR = 1.27, 95% CI: 1.11, 1.45). These associations were not explained by high body mass. Our findings suggest that diabetes is an independent predictor of mortality from cancer of the colon, pancreas, female breast, and, in men, of the liver and bladder.

breast neoplasms; cohort studies; colonic neoplasms; diabetes mellitus; liver neoplasms; obesity; pancreatic neoplasms; prostatic neoplasms

Abbreviations: Abbreviations: BMI, body mass index; CI, confidence interval; IGF-1, insulin-like growth factor 1; RR, relative risk.


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