title: Associations of diabetes mellitus with site-specific cancer mortality in the Asia-Pacific region.
abstract: BACKGROUND
  Owing to the increasing prevalence of obesity and diabetes in Asia, and the paucity of studies, we examined the influence of raised blood glucose and diabetes on cancer mortality risk.
  
  
  METHODS
  Thirty-six cohort Asian and Australasian studies provided 367, 361 participants (74% from Asia); 6% had diabetes at baseline. Associations between diabetes and site-specific cancer mortality were estimated using time-dependent Cox models, stratified by study and sex, and adjusted for age.
  
  
  RESULTS
  During a median follow-up of 4.0 years, there were 5992 deaths due to cancer (74% Asian; 41% female). Participants with diabetes had 23% greater risk of mortality from all-cause cancer compared with those without: hazard ratio (HR) 1.23 [95% confidence interval (CI) 1.12, 1.35]. Diabetes was associated with mortality due to cancer of the liver (HR 1.51; 95% CI 1.19, 1.91), pancreas (HR 1.78; 95% CI 1.20, 2.65), and, less strongly, colorectum (HR 1.32; 95% CI 0.98, 1.78). There was no evidence of sex- or region-specific differences in these associations. The population attributable fractions for cancer mortality due to diabetes were generally higher for Asia compared with non-Asian populations.
  
  
  CONCLUSIONS
  Diabetes is associated with increased mortality from selected cancers in Asian and non-Asian populations.
authors: Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK; The George Institute for International Health, University of Sydney, Sydney, Australia; Department of Community Health and Epidemiology, School of Medicine, Queen's University, Kingston, Canada.
authors: E K K
authors: EKK
authors: Lam
authors: The George Institute for International Health, University of Sydney, Sydney, Australia; Medical Research Council Social & Public Health Sciences Unit, Glasgow, UK.
authors: G D
authors: GD
authors: Batty
authors: The George Institute for International Health, University of Sydney, Sydney, Australia; Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, USA.
authors: R R
authors: RR
authors: Huxley
authors: The George Institute for International Health, University of Sydney, Sydney, Australia. Electronic address: amartiniuk@george.org.au.
authors: A L C
authors: ALC
authors: Martiniuk
authors: The George Institute for International Health, University of Sydney, Sydney, Australia.
authors: F
authors: F
authors: Barzi
authors: School of Public Health, The University of Hong Kong, Hong Kong, China.
authors: T H
authors: TH
authors: Lam
authors: Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand.
authors: C M M
authors: CMM
authors: Lawes
authors: Cancer Epidemiology Centre, The Cancer Council, Victoria; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne; Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Melbourne.
authors: G G
authors: GG
authors: Giles
authors: Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
authors: T
authors: T
authors: Welborn
authors: Department of Health Science, Shiga University of Medical Science, Shiga.
authors: H
authors: H
authors: Ueshima
authors: Department of Public Health, Aichi Medical University School of Medicine, Aichi-gun, Japan.
authors: A
authors: A
authors: Tamakoshi
authors: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
authors: J
authors: J
authors: Woo
authors: Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea.
authors: H C
authors: HC
authors: Kim
authors: The George Institute for International Health, University of Sydney, Sydney, Australia; Department of Epidemiology and Social Medicine, Capital Medical University, Beijing, China.
authors: X
authors: X
authors: Fang
authors: The George Institute for International Health, University of Sydney, Sydney, Australia; Nutritional Epidemiology Research Unit, Public Health Department, Hôpital Avicenne & University Paris 13, Faculté SMBH, Bobigny, France.
authors: S
authors: S
authors: Czernichow
authors: The George Institute for International Health, University of Sydney, Sydney, Australia; Department of Epidemiology, Johns Hopkins University, Baltimore, USA.
authors: M
authors: M
authors: Woodward
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia; D044362:Australasia; D001786:Blood Glucose; D015331:Cohort Studies; D048909:Diabetes Complications / Q000150:complications* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000401:mortality*; D016017:Odds Ratio
chemical_list: D001786:Blood Glucose