title: Prevalence of Cancers of Female Organs among Patients with Diabetes Type 2 in Kelantan, Malaysia: Observations over an 11 Year Period and Strategies to Reduce the Incidence.
abstract: BACKGROUND
  Kelantan is one of the states in Malaysia which has a high prevalence of type 2 diabetes (DM2). Other than with endometrial carcinoma, the association of DM2 with particular female cancers is not known.
  
  
  OBJECTIVE
  To determine the proportion of breast, cervical, ovarian and endometrial cancers among females with DM2 diagnosed in Hospital Universiti Sains Malaysia (HUSM) over an 11 year period.
  
  
  METHODS
  All histologically confirmed cases of breast, endometrial, cervical and ovarian carcinomas admitted to the Hospital were included in the study. The patient diabetic status was traced from the hospital medical records.
  
  
  RESULTS
  There was a total of 860 cases of breast, cervical, ovarian and endometrial carcinomas over this period. Breast carcinoma was the commonest, accounting for 437/860 (50.8%) followed by cervix, 159/860 (18.5%), ovarian, 143/860 (16.6%) and endometrial carcinomas, 121/860 (14.1%). Out of these, 228/860 (26.5%) were confirmed diabetics. Endometrial carcinoma patients showed the highest proportion being diabetics, 42.1% (51/121), followed by ovarian cancer, 25.9% (37/143), breast carcinoma, 23.6% (103/437) and cervical cancer 23.3% (37/159).
  
  
  CONCLUSIONS
  There is a significant proportion of DM2 among women with these four cancers, endometrial carcinoma being the highest followed by ovarian, breast and cervical carcinoma. The rising trend of these four cancers is in tandem with an increasing trend of DM2 in the community. In populations where diabetes is prevalent, screening for epithelial cancers should be rigourous. Diabetic clinics should include screening for these cancers among their female patients and gynecology clinics should screen the women they treat for their diabetes status.
authors.affiliation: Department of Pathology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Malaysia E-mail : hayatikb@usm.my.
authors.forename: Nur Asyilla Che
authors.initials: NA
authors.lastname: Jalil
authors.forename: Anani Aila Mat
authors.initials: AA
authors.lastname: Zin
authors.forename: Nor Hayati
authors.initials: NH
authors.lastname: Othman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008296:Malaysia / Q000453:epidemiology; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult