title: Association between type 2 diabetes and cancer incidence in Taiwan: data from a prospective community-based cohort study.
abstract: OBJECTIVE
  Evidence of a role for type 2 diabetes in overall cancer risk and risk for specific types of cancer is limited in ethnic Chinese populations. We therefore investigated whether there is an association between diabetes and cancer incidence in Taiwan.
  
  
  METHODS
  This study recruited a total of 3602 adults aged 35 years or over (average 54.9 ± 12.3 years, 52.8% women). Participants with fasting glucose ≥126 mg/dL, or taking hypoglycemic medications, were classed as having type 2 diabetes. Cancer incidence was established through regular follow-up interviews and medical records. Cox proportional hazard regression models were used to examine associations for diabetes with risk of all-cause and site-specific cancers.
  
  
  RESULTS
  During a median of follow-up of 10.5 years, 275 individuals developed cancer, including 157 digestive cancers and 31 urinary cancers. Younger participants (aged < 55 years) with diabetes had a greater risk of all cancers [adjusted relative risk (RR) 3.42; 95% confidence interval (CI), 1.78-6.57], digestive cancers (adjusted RR 2.88; 95% CI 1.15-6.94) and urinary cancers (adjusted RR 13.4; 95% CI 2.70-66.3) compared with individuals in the same age group without diabetes.
  
  
  CONCLUSIONS
  Our results clearly demonstrate that middle-aged individuals of Chinese ethnicity with diabetes have a greater risk of all-cause cancer and specific subtypes of cancer.
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Wei-Sin
authors.initials: WS
authors.lastname: Yang
authors.affiliation: Department of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Pei-Chun
authors.initials: PC
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Hung-Ju
authors.initials: HJ
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ta-Chen
authors.initials: TC
authors.lastname: Su
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Hsiu-Ching
authors.initials: HC
authors.lastname: Hsu
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ming-Fong
authors.initials: MF
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Yuan-Teh
authors.initials: YT
authors.lastname: Lee
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. klchien@ntu.edu.tw.|Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. klchien@ntu.edu.tw.
authors.forename: Kuo-Liong
authors.identifier: http://orcid.org/0000-0003-4979-8351
authors.initials: KL
authors.lastname: Chien
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: Cancer; Cohort study; Type 2 diabetes