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Prevalent diabetes and risk of total, colorectal, prostate and breast cancers in an ageing population: meta-analysis of individual participant data from cohorts of the CHANCES consortium.

International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, Lyon, France. Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France. International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, Lyon, France. freislingh@iarc.fr. Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. Hellenic Health Foundation, Athens, Greece. Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. Department of Radiation Sciences, Oncology Umeå University, Umeå, Sweden. Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden. Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain. Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway. Institute for Health Sciences Risk and Inequality, Centre for Public Health, Belfast, UK. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany. Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Woodstock Road, Oxford, UK. NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands. Public Health Directorate, Asturias, Spain. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany. German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.

British journal of cancer. 2021;(11):1882-1890
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Abstract

BACKGROUND We investigated whether associations between prevalent diabetes and cancer risk are pertinent to older adults and whether associations differ across subgroups of age, body weight status or levels of physical activity. METHODS We harmonised data from seven prospective cohort studies of older individuals in Europe and the United States participating in the CHANCES consortium. Cox proportional hazard regression was used to estimate the associations of prevalent diabetes with cancer risk (all cancers combined, and for colorectum, prostate and breast). We calculated summary risk estimates across cohorts using pooled analysis and random-effects meta-analysis. RESULTS A total of 667,916 individuals were included with an overall median (P25-P75) age at recruitment of 62.3 (57-67) years. During a median follow-up time of 10.5 years, 114,404 total cancer cases were ascertained. Diabetes was not associated with the risk of all cancers combined (hazard ratio (HR) = 0.94; 95% confidence interval (CI): 0.86-1.04; I2 = 63.3%). Diabetes was positively associated with colorectal cancer risk in men (HR = 1.17; 95% CI: 1.08-1.26; I2 = 0%) and a similar HR in women (1.13; 95% CI: 0.82-1.56; I2 = 46%), but with a confidence interval including the null. Diabetes was inversely associated with prostate cancer risk (HR = 0.81; 95% CI: 0.77-0.85; I2 = 0%), but not with postmenopausal breast cancer (HR = 0.96; 95% CI: 0.89-1.03; I2 = 0%). In exploratory subgroup analyses, diabetes was inversely associated with prostate cancer risk only in men with overweight or obesity. CONCLUSIONS Prevalent diabetes was positively associated with colorectal cancer risk and inversely associated with prostate cancer risk in older Europeans and Americans.

Methodological quality

Publication Type : Meta-Analysis

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MeSH terms : Aging ; Diabetes Mellitus ; Neoplasms