title: Increased cancer incidence risk in type 2 diabetes mellitus: results from a cohort study in Tyrol/Austria.
abstract: BACKGROUND
  Recent meta-analyses revealed an association between type 2 diabetes mellitus (T2DM) and cancer. The strongest relationship was demonstrated for liver and pancreatic cancer, followed by endometrial cancer. We aimed at assessing the association between T2DM and cancer specifically for Tyrolean patients.
  
  
  METHODS
  We investigated cancer incidence in Tyrolean subjects with T2DM by linking the data from the Diabetes and the Cancer Registries. 5709 T2DM patients were included and the sex- and age-adjusted standardized incidence ratio (SIR) was calculated, cancer incidence in the Tyrolean population serving as the standard. Endpoints were the time at which cancer was diagnosed, death or end of the observation period (31 December 2010).
  
  
  RESULTS
  Site-specific analyses revealed statistically significantly elevated SIRs for cancer of the pancreas (1.78, 95% CI 1.02, 2.89) and corpus (1.79, 95% CI 1.15, 2.66) for women, and cancer of the liver (2.71, 95% CI 1.65, 4.18) and pancreas (1.87, 95% 1.11, 2.96) for men. Sub-analyses performed according to the time of diabetes diagnosis revealed that SIR was highest in the first year after diabetes diagnosis, but SIR was demonstrated to be elevated in women for cancer of the liver (SIR 3.37, 95% CI 1.24, 7.34) and corpus (SIR 1.94, 95% CI 1.09, 3.20) and in men for liver (SIR 2.71, 95% CI 1.40, 4.74) in the period more than five years after diabetes diagnosis. In addition, increased risk at borderline statistical significance was observed in females for liver cancer (SIR 2.40, 95% CI 0.96, 4.94) and cervical cancer (SIR 1.81, 95% CI 0.87, 3.32) and in males for kidney cancer (SIR 1.65, 95% CI 0.99, 2.57).
  
  
  CONCLUSIONS
  This study revealed a higher risk for cancer at certain sites in Tyrolean patients with T2DM. However, it is important to interpret the results with great caution due to inherent methodological problems. Optimized care programs for patients with T2DM should be integrated into the recommended procedures for cancer screening.
authors.affiliation: Department of Clinical Epidemiology of the Tyrolean State Hospitals Ltd, Cancer Registry of Tyrol, TILAK GmbH, Anichstrasse 35, Innsbruck, Austria. willi.oberaigner@tilak.at.
authors.forename: Willi
authors.initials: W
authors.lastname: Oberaigner
authors.forename: Christoph
authors.initials: C
authors.lastname: Ebenbichler
authors.forename: Karin
authors.initials: K
authors.lastname: Oberaigner
authors.forename: Martin
authors.initials: M
authors.lastname: Juchum
authors.forename: Hans Robert
authors.initials: HR
authors.lastname: Schönherr
authors.forename: Monika
authors.initials: M
authors.lastname: Lechleitner
mesh_terms: D000368:Aged; D001317:Austria / Q000453:epidemiology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000209:etiology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D012737:Sex Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000209:etiology; D014594:Uterine Neoplasms / Q000453:epidemiology / Q000209:etiology*