Association between glycosylated hemoglobin and cancer risk: a New Zealand linkage study.
BACKGROUND
The purpose of this study was to examine the relationship between glycosylated hemoglobin (HbA(1c)) level and subsequent cancer risk.


METHODS
HbA(1c) measurements were made on blood samples of participants in a hepatitis B (HB) screening program (1999-2001). Cancer incidence was determined by linkage to cancer registrations and hospitalization records to the end of 2004. Participants previously diagnosed with diabetes or cancer were excluded. Hazard ratios (HR) and 95% confidence intervals (CIs) were estimated using Cox regression.


RESULTS
Among the 46 575 participants (70% Māori, 12% Pacific, 5% Asian and 12% Other), 634 cancer cases were observed. For all cancers combined, a significant increased risk was found in persons with moderately elevated HbA(1c) levels (6%-6.9%) (HR 1.40, 95% CI: 1.11-1.76), with a smaller increased risk in persons with highly elevated levels (> or =7%) (HR 1.09, 95% CI: 0.80-1.48) as compared with persons having low HbA(1c) levels (<6%). The HRs for respiratory cancers were 2.27 (95% CI: 1.34-3.86) for the moderate HbA(1c) category and 1.58 (95% CI: 0.77-3.26) for the upper HbA(1c) category. For endometrial cancers, the HRs were 4.05 (95% CI: 1.10-14.88) and 5.07 (95% CI: 1.20-21.31), respectively. For other cancer sites, no significantly increased risks were found.


CONCLUSIONS
These findings are consistent with other evidence that abnormal glucose metabolism may be associated with an increased risk of some cancers.
Travier
N
N
Centre for Public Health Research, Massey University, Wellington, New Zealand. n.travier@massey.ac.nz
Jeffreys
M
M
Brewer
N
N
Wright
C S
CS
Cunningham
C W
CW
Hornell
J
J
Pearce
N
N
D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000453:epidemiology*; D009520:New Zealand / Q000453:epidemiology; D012307:Risk Factors
D014408:Biomarkers, Tumor; D006442:Glycated Hemoglobin