Glucose tolerance status and 20 year cancer incidence.
BACKGROUND
Type 2 diabetes, an extreme state of glucose intolerance, has been found to be associated with cancer mortality; less is known about impaired glucose tolerance and cancer incidence.


OBJECTIVE
To examine the association between fasting and post-load plasma glucose and insulin, and the 20 year incidence of cancer.


METHODS
We followed a sample of the Jewish Israeli population (n = 2780), free of cancer at baseline, from 1977-1980 to 1999 for cancer incidence and mortality. Baseline fasting and 1 and 2 hour post-load plasma glucose levels were recorded, as was insulin, in 1797 of them.


RESULTS
During 20 years, 329 individuals (11.8%) developed cancer. Cancer incidence for all sites differed between men and women (13.0% and 10.7%, P = 0.03), and among different glucose tolerance status groups (P = 0.01). Cancer incidence hazard ratio, by glucose status adjusted for gender, age, ethnicity, smoking and body mass index, was 1.24 (95% CI 0.96-1.62, P = 0.10) for impaired fasting glucose or impaired glucose tolerance, and 1.32 (95% CI 0.96-1.81, P = 0.09) for type 2 diabetes mellitus, compared with those who were normoglycemic at baseline. Fasting insulin and cancer incidence were not associated.


CONCLUSIONS
An increased long-term cancer risk for individuals with impaired fasting glucose or glucose tolerance, or diabetes, is suggested. Even this modest association could have substantial public health consequences.
Dankner
Rachel
R
Unit for Cardiovascular Epidemiology, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel. racheld@gertner.health.gov.il
Chetrit
Angela
A
Segal
Pesach
P
D001786:Blood Glucose / Q000032:analysis*; D016009:Chi-Square Distribution; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000453:epidemiology*; D016016:Proportional Hazards Models
D001786:Blood Glucose