Diabetes mellitus and cancer of the digestive organs: An Italian population-based cohort study.
OBJECTIVE
The association between diabetes mellitus and the occurrence of digestive organs cancers was investigated in the Italian region Friuli Venezia Giulia. The risk of cancer associated with oral antidiabetic drugs among subjects with type 2 diabetes was also assessed.


METHODS
This was a retrospective population-based cohort study based on the 2002-2014 regional administrative health data. Incident digestive cancers were identified through the hospital discharge diagnoses. The incidence rates of cancer at different sites were calculated for type 1 and 2 diabetics and for non-diabetics. Proportional hazard models were built to assess the risk of cancer associated with diabetes and antidiabetic drugs.


RESULTS
Diabetes was associated with increased risk of digestive cancers. Liver and pancreatic cancers were associated with the highest hazard ratios. Among type 2 diabetics, total number of metformin prescriptions was associated with reduced risk of most types of digestive cancers; sulfonylureas with reduced risk of stomach and pancreatic cancer.


CONCLUSIONS
In this Italian population the excess risk of digestive cancers for diabetic patients was confirmed. Further research is needed to clarify the role of antidiabetic drugs.
Epidemiological Service, Regional Health Directorate, Region Friuli Venezia Giulia, Via Pozzuolo 330, 33100 Udine, Italy. Electronic address: francesca.valent@regione.fvg.it.
Francesca
F
Valent
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D004067:Digestive System Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008113:Liver Neoplasms / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012306:Risk; D055815:Young Adult
D000960:Hypolipidemic Agents
Cancer; Cohort study; Diabetes mellitus; Metformin; Sulfonylureas; Thiazolidinediones