Cancer incidence in patients with type 1 diabetes mellitus: a population-based cohort study in Sweden.
Although patients with type 2 diabetes have elevated risks of liver, pancreatic, kidney, and endometrial cancer, little is known about the risk of cancer for patients with type 1 diabetes. We conducted a cohort study to examine cancer incidence among 29 187 patients in Sweden who were hospitalized for type 1 diabetes from 1965 through 1999. Relative risks of cancer were estimated by age-, sex- and calendar year of follow-up--adjusted standardized incidence ratios (SIRs), using data for the entire Swedish population as a reference. After excluding cancers diagnosed during the first year after hospital discharge, we observed 355 incident cases of cancer, which corresponded to a 20% increase in overall cancer incidence among type 1 diabetes patients (SIR = 1.2, 95% confidence interval [CI] = 1.0 to 1.3). Patients with type 1 diabetes had elevated risks of cancers of the stomach (SIR = 2.3, 95% CI = 1.1 to 4.1), cervix (SIR = 1.6, 95% CI = 1.1 to 2.2), and endometrium (SIR = 2.7, 95% CI = 1.4 to 4.7). Type 1 diabetes is associated with a modest excess cancer risk overall and risks of specific cancers that differ from those associated with type 2 diabetes.
Zendehdel
Kazem
K
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Nyrén
Olof
O
Ostenson
Claes-Göran
CG
Adami
Hans-Olov
HO
Ekbom
Anders
A
Ye
Weimin
W
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism; D016889:Endometrial Neoplasms / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007328:Insulin / Q000378:metabolism; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism; D012042:Registries; D018570:Risk Assessment; D013548:Sweden / Q000453:epidemiology
D007328:Insulin