title: Does cancer risk increase with HbA1c, independent of diabetes?
abstract: BACKGROUND
  The risks for several cancer types are increased in people with diabetes. Hyperglycaemia, hyperinsulinaemia, inflammation and altered hormonal concentrations are common characteristics between the two diseases and can all be linked to hyperglycaemia.
  
  
  METHODS
  Here, we use glycated haemoglobin (HbA1c) as a biomarker for chronic hyperglycaemia. We explore whether cancer risk increases with HbA1c, independent of diabetes, and, therefore, if risk is already increased below the diabetic HbA1c range, by analysing data from current studies linking HbA1c to risk of several cancer types.
  
  
  RESULTS
  The data reveal that chronic hyperglycaemia correlates with increased cancer risk for a number of cancers, except prostate cancer. Evidence is also provided that risk is already increased in the pre-diabetic and normal ranges for several cancers.
  
  
  CONCLUSIONS
  These results merit urgent investigation into the risks and advantages of updating recommendations for stricter glycaemic control in diabetic and non-diabetic subjects, as this could help reduce the risk of cancer incidence and mortality.
authors.affiliation: Center for Research and Continued Engineering Development, North-West University (Pretoria Campus), Suite No. 91, Private Bag X30, Lynnwood Ridge, Pretoria 0040, South Africa.
authors.forename: J C
authors.initials: JC
authors.lastname: de Beer
authors.affiliation: 1] Center for Research and Continued Engineering Development, North-West University (Pretoria Campus), Suite No. 91, Private Bag X30, Lynnwood Ridge, Pretoria 0040, South Africa [2] TEMM International (Pty) Ltd, Pretoria, South Africa.
authors.forename: L
authors.initials: L
authors.lastname: Liebenberg
mesh_terms: D015415:Biomarkers / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D004305:Dose-Response Relationship, Drug; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D009369:Neoplasms / Q000097:blood / Q000453:epidemiology*; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human