title: Blood glucose and risk of incident and fatal cancer in the metabolic syndrome and cancer project (me-can): analysis of six prospective cohorts.
abstract: BACKGROUND
  Prospective studies have indicated that elevated blood glucose levels may be linked with increased cancer risk, but the strength of the association is unclear. We examined the association between blood glucose and cancer risk in a prospective study of six European cohorts.
  
  
  RESULTS
  The Metabolic syndrome and Cancer project (Me-Can) includes cohorts from Norway, Austria, and Sweden; the current study included 274,126 men and 275,818 women. Mean age at baseline was 44.8 years and mean follow-up time was 10.4 years. Excluding the first year of follow-up, 18,621 men and 11,664 women were diagnosed with cancer, and 6,973 men and 3,088 women died of cancer. We used Cox regression models to calculate relative risk (RR) for glucose levels, and included adjustment for body mass index (BMI) and smoking status in the analyses. RRs were corrected for regression dilution ratio of glucose. RR (95% confidence interval) per 1 mmol/l increment of glucose for overall incident cancer was 1.05 (1.01-1.10) in men and 1.11 (1.05-1.16) in women, and corresponding RRs for fatal cancer were 1.15 (1.07-1.22) and 1.21 (1.11-1.33), respectively. Significant increases in risk among men were found for incident and fatal cancer of the liver, gallbladder, and respiratory tract, for incident thyroid cancer and multiple myeloma, and for fatal rectal cancer. In women, significant associations were found for incident and fatal cancer of the pancreas, for incident urinary bladder cancer, and for fatal cancer of the uterine corpus, cervix uteri, and stomach.
  
  
  CONCLUSIONS
  Data from our study indicate that abnormal glucose metabolism, independent of BMI, is associated with an increased risk of cancer overall and at several cancer sites. Our data showed stronger associations among women than among men, and for fatal cancer compared to incident cancer. Please see later in the article for the Editors' Summary.
authors.affiliation: Department of Surgical and Perioperative sciences, Urology and Andrology, Umeå University, Umeå, Sweden. tanja.stocks@urologi.umu.se
authors.forename: Tanja
authors.initials: T
authors.lastname: Stocks
authors.forename: Kilian
authors.initials: K
authors.lastname: Rapp
authors.forename: Tone
authors.initials: T
authors.lastname: Bjørge
authors.forename: Jonas
authors.initials: J
authors.lastname: Manjer
authors.forename: Hanno
authors.initials: H
authors.lastname: Ulmer
authors.forename: Randi
authors.initials: R
authors.lastname: Selmer
authors.forename: Annekatrin
authors.initials: A
authors.lastname: Lukanova
authors.forename: Dorthe
authors.initials: D
authors.lastname: Johansen
authors.forename: Hans
authors.initials: H
authors.lastname: Concin
authors.forename: Steinar
authors.initials: S
authors.lastname: Tretli
authors.forename: Göran
authors.initials: G
authors.lastname: Hallmans
authors.forename: Håkan
authors.initials: H
authors.lastname: Jonsson
authors.forename: Pär
authors.initials: P
authors.lastname: Stattin
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology*; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000453:epidemiology*; D011446:Prospective Studies; D018570:Risk Assessment
chemical_list: D001786:Blood Glucose