CARING (CAncer Risk and INsulin analoGues): the association of diabetes mellitus and cancer risk with focus on possible determinants - a systematic review and a meta-analysis

Jakob Starup-Linde; Oystein Karlstad; Stine Aistrup Eriksen; Peter Vestergaard; Heleen K Bronsveld; Frank de Vries; Morten Andersen; Anssi Auvinen; Jari Haukka; Vidar Hjellvik; Marloes T Bazelier; Anthonius de Boer; Kari Furu; Marie L De Bruin

CARING (CAncer Risk and INsulin analoGues): the association of diabetes mellitus and cancer risk with focus on possible determinants - a systematic review and a meta-analysis

Jakob Starup-Linde, Oystein Karlstad, Stine Aistrup Eriksen, Peter Vestergaard, Heleen K Bronsveld, Frank de Vries, Morten Andersen, Anssi Auvinen, Jari Haukka, Vidar Hjellvik, Marloes T Bazelier, Anthonius de Boer, Kari Furu, Marie L De Bruin

32 Citations (Scopus)

Abstract

BACKGROUND: Patients suffering from diabetes mellitus (DM) may experience an increased risk of cancer; however, it is not certain whether this effect is due to diabetes per se.

OBJECTIVE: To examine the association between DM and cancers by a systematic review and meta-analysis according to the PRISMA guidelines.

DATA SOURCES: The systematic literature search includes Medline at PubMed, Embase, Cinahl, Bibliotek.dk, Cochrane library, Web of Science and SveMed+ with the search terms: "Diabetes mellitus", "Neoplasms", and "Risk of cancer".

STUDY ELIGIBILITY CRITERIA: The included studies compared the risk of cancer in diabetic patients versus non-diabetic patients. All types of observational study designs were included.

RESULTS: Diabetes patients were at a substantially increased risk of liver (RR=2.1), and pancreas (RR=2.2) cancer. Modestly elevated significant risks were also found for ovary (RR=1.2), breast (RR=1.1), cervix (RR=1.3), endometrial (RR=1.4), several digestive tract (RR=1.1-1.5), kidney (RR=1.4), and bladder cancer (RR=1.1). The findings were similar for men and women, and unrelated to study design. Meta-regression analyses showed limited effect modification of body mass index, and possible effect modification of age, gender, with some influence of study characteristics (population source, cancer- and diabetes ascertainment).

LIMITATIONS: Publication bias seemed to be present. Only published data were used in the analyses.

CONCLUSIONS: The systematic review and meta-analysis confirm the previous results of increased cancer risk in diabetes and extend this to additional cancer sites. Physicians in contact with patients with diabetes should be aware that diabetes patients are at an increased risk of cancer.

Original language	English
Journal	Current Drug Safety
Volume	8
Issue number	5
Pages (from-to)	296-332
Number of pages	37
ISSN	1574-8863
Publication status	Published - Dec 2013
Externally published	Yes

Keywords

Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Diabetes Complications
Diabetes Mellitus
Humans
Hypoglycemic Agents
Infant
Insulin
Middle Aged
Neoplasms
Publication Bias
Regression Analysis
Risk
Young Adult
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Starup-Linde, J., Karlstad, O., Eriksen, S. A., Vestergaard, P., Bronsveld, H. K., de Vries, F., Andersen, M., Auvinen, A., Haukka, J., Hjellvik, V., Bazelier, M. T., Boer, A. D., Furu, K., & De Bruin, M. L. (2013). CARING (CAncer Risk and INsulin analoGues): the association of diabetes mellitus and cancer risk with focus on possible determinants - a systematic review and a meta-analysis. Current Drug Safety, 8(5), 296-332.

CARING (CAncer Risk and INsulin analoGues) : the association of diabetes mellitus and cancer risk with focus on possible determinants - a systematic review and a meta-analysis. / Starup-Linde, Jakob; Karlstad, Oystein; Eriksen, Stine Aistrup et al.

In: Current Drug Safety, Vol. 8, No. 5, 12.2013, p. 296-332.

Research output: Contribution to journal › Journal article › Research › peer-review

Starup-Linde, J, Karlstad, O, Eriksen, SA, Vestergaard, P, Bronsveld, HK, de Vries, F, Andersen, M, Auvinen, A, Haukka, J, Hjellvik, V, Bazelier, MT, Boer, AD, Furu, K & De Bruin, ML 2013, 'CARING (CAncer Risk and INsulin analoGues): the association of diabetes mellitus and cancer risk with focus on possible determinants - a systematic review and a meta-analysis', Current Drug Safety, vol. 8, no. 5, pp. 296-332.

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title = "CARING (CAncer Risk and INsulin analoGues): the association of diabetes mellitus and cancer risk with focus on possible determinants - a systematic review and a meta-analysis",

abstract = "BACKGROUND: Patients suffering from diabetes mellitus (DM) may experience an increased risk of cancer; however, it is not certain whether this effect is due to diabetes per se.OBJECTIVE: To examine the association between DM and cancers by a systematic review and meta-analysis according to the PRISMA guidelines.DATA SOURCES: The systematic literature search includes Medline at PubMed, Embase, Cinahl, Bibliotek.dk, Cochrane library, Web of Science and SveMed+ with the search terms: {"}Diabetes mellitus{"}, {"}Neoplasms{"}, and {"}Risk of cancer{"}.STUDY ELIGIBILITY CRITERIA: The included studies compared the risk of cancer in diabetic patients versus non-diabetic patients. All types of observational study designs were included.RESULTS: Diabetes patients were at a substantially increased risk of liver (RR=2.1), and pancreas (RR=2.2) cancer. Modestly elevated significant risks were also found for ovary (RR=1.2), breast (RR=1.1), cervix (RR=1.3), endometrial (RR=1.4), several digestive tract (RR=1.1-1.5), kidney (RR=1.4), and bladder cancer (RR=1.1). The findings were similar for men and women, and unrelated to study design. Meta-regression analyses showed limited effect modification of body mass index, and possible effect modification of age, gender, with some influence of study characteristics (population source, cancer- and diabetes ascertainment).LIMITATIONS: Publication bias seemed to be present. Only published data were used in the analyses.CONCLUSIONS: The systematic review and meta-analysis confirm the previous results of increased cancer risk in diabetes and extend this to additional cancer sites. Physicians in contact with patients with diabetes should be aware that diabetes patients are at an increased risk of cancer.",

keywords = "Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Diabetes Complications, Diabetes Mellitus, Humans, Hypoglycemic Agents, Infant, Insulin, Middle Aged, Neoplasms, Publication Bias, Regression Analysis, Risk, Young Adult, Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review",

author = "Jakob Starup-Linde and Oystein Karlstad and Eriksen, {Stine Aistrup} and Peter Vestergaard and Bronsveld, {Heleen K} and {de Vries}, Frank and Morten Andersen and Anssi Auvinen and Jari Haukka and Vidar Hjellvik and Bazelier, {Marloes T} and Boer, {Anthonius de} and Kari Furu and {De Bruin}, {Marie L}",

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language = "English",

volume = "8",

pages = "296--332",

journal = "Current Drug Safety",

issn = "1574-8863",

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number = "5",

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T1 - CARING (CAncer Risk and INsulin analoGues)

T2 - the association of diabetes mellitus and cancer risk with focus on possible determinants - a systematic review and a meta-analysis

AU - Starup-Linde, Jakob

AU - Karlstad, Oystein

AU - Eriksen, Stine Aistrup

AU - Vestergaard, Peter

AU - Bronsveld, Heleen K

AU - de Vries, Frank

AU - Andersen, Morten

AU - Auvinen, Anssi

AU - Haukka, Jari

AU - Hjellvik, Vidar

AU - Bazelier, Marloes T

AU - Boer, Anthonius de

AU - Furu, Kari

AU - De Bruin, Marie L

PY - 2013/12

Y1 - 2013/12

N2 - BACKGROUND: Patients suffering from diabetes mellitus (DM) may experience an increased risk of cancer; however, it is not certain whether this effect is due to diabetes per se.OBJECTIVE: To examine the association between DM and cancers by a systematic review and meta-analysis according to the PRISMA guidelines.DATA SOURCES: The systematic literature search includes Medline at PubMed, Embase, Cinahl, Bibliotek.dk, Cochrane library, Web of Science and SveMed+ with the search terms: "Diabetes mellitus", "Neoplasms", and "Risk of cancer".STUDY ELIGIBILITY CRITERIA: The included studies compared the risk of cancer in diabetic patients versus non-diabetic patients. All types of observational study designs were included.RESULTS: Diabetes patients were at a substantially increased risk of liver (RR=2.1), and pancreas (RR=2.2) cancer. Modestly elevated significant risks were also found for ovary (RR=1.2), breast (RR=1.1), cervix (RR=1.3), endometrial (RR=1.4), several digestive tract (RR=1.1-1.5), kidney (RR=1.4), and bladder cancer (RR=1.1). The findings were similar for men and women, and unrelated to study design. Meta-regression analyses showed limited effect modification of body mass index, and possible effect modification of age, gender, with some influence of study characteristics (population source, cancer- and diabetes ascertainment).LIMITATIONS: Publication bias seemed to be present. Only published data were used in the analyses.CONCLUSIONS: The systematic review and meta-analysis confirm the previous results of increased cancer risk in diabetes and extend this to additional cancer sites. Physicians in contact with patients with diabetes should be aware that diabetes patients are at an increased risk of cancer.

AB - BACKGROUND: Patients suffering from diabetes mellitus (DM) may experience an increased risk of cancer; however, it is not certain whether this effect is due to diabetes per se.OBJECTIVE: To examine the association between DM and cancers by a systematic review and meta-analysis according to the PRISMA guidelines.DATA SOURCES: The systematic literature search includes Medline at PubMed, Embase, Cinahl, Bibliotek.dk, Cochrane library, Web of Science and SveMed+ with the search terms: "Diabetes mellitus", "Neoplasms", and "Risk of cancer".STUDY ELIGIBILITY CRITERIA: The included studies compared the risk of cancer in diabetic patients versus non-diabetic patients. All types of observational study designs were included.RESULTS: Diabetes patients were at a substantially increased risk of liver (RR=2.1), and pancreas (RR=2.2) cancer. Modestly elevated significant risks were also found for ovary (RR=1.2), breast (RR=1.1), cervix (RR=1.3), endometrial (RR=1.4), several digestive tract (RR=1.1-1.5), kidney (RR=1.4), and bladder cancer (RR=1.1). The findings were similar for men and women, and unrelated to study design. Meta-regression analyses showed limited effect modification of body mass index, and possible effect modification of age, gender, with some influence of study characteristics (population source, cancer- and diabetes ascertainment).LIMITATIONS: Publication bias seemed to be present. Only published data were used in the analyses.CONCLUSIONS: The systematic review and meta-analysis confirm the previous results of increased cancer risk in diabetes and extend this to additional cancer sites. Physicians in contact with patients with diabetes should be aware that diabetes patients are at an increased risk of cancer.

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KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Child

KW - Child, Preschool

KW - Diabetes Complications

KW - Diabetes Mellitus

KW - Humans

KW - Hypoglycemic Agents

KW - Infant

KW - Insulin

KW - Middle Aged

KW - Neoplasms

KW - Publication Bias

KW - Regression Analysis

KW - Risk

KW - Young Adult

KW - Journal Article

KW - Meta-Analysis

KW - Research Support, Non-U.S. Gov't

KW - Review

M3 - Journal article

C2 - 24215312

SN - 1574-8863

VL - 8

SP - 296

EP - 332

JO - Current Drug Safety

JF - Current Drug Safety

IS - 5

ER -

CARING (CAncer Risk and INsulin analoGues): the association of diabetes mellitus and cancer risk with focus on possible determinants - a systematic review and a meta-analysis

Abstract

Keywords

UN SDGs

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