title: Association between type 2 diabetes and risk of cancer mortality: a pooled analysis of over 771,000 individuals in the Asia Cohort Consortium.
abstract: The aims of the study were to evaluate the association between type 2 diabetes and the risk of death from any cancer and specific cancers in East and South Asians.
  
  
  
  Pooled analyses were conducted of 19 prospective population-based cohorts included in the Asia Cohort Consortium, comprising data from 658,611 East Asians and 112,686 South Asians. HRs were used to compare individuals with diabetes at baseline with those without diabetes for the risk of death from any cancer and from site-specific cancers, including cancers of the oesophagus, stomach, colorectum, colon, rectum, liver, bile duct, pancreas, lung, breast, endometrium, cervix, ovary, prostate, bladder, kidney and thyroid, as well as lymphoma and leukaemia.
  
  
  
  During a mean follow-up of 12.7 years, 37,343 cancer deaths (36,667 in East Asians and 676 in South Asians) were identified. Baseline diabetes status was statistically significantly associated with an increased risk of death from any cancer (HR 1.26; 95% CI 1.21, 1.31). Significant positive associations with diabetes were observed for cancers of the colorectum (HR 1.41; 95% CI 1.26, 1.57), liver (HR 2.05; 95% CI 1.77, 2.38), bile duct (HR 1.41; 95% CI 1.04, 1.92), gallbladder (HR 1.33; 95% CI 1.10, 1.61), pancreas (HR 1.53; 95% CI 1.32, 1.77), breast (HR 1.72; 95% CI 1.34, 2.19), endometrium (HR 2.73; 95% CI 1.53, 4.85), ovary (HR 1.60; 95% CI 1.06, 2.42), prostate (HR 1.41; 95% CI 1.09, 1.82), kidney (HR 1.84; 95% CI 1.28, 2.64) and thyroid (HR 1.99; 95% CI 1.03, 3.86), as well as lymphoma (HR 1.39; 95% CI 1.04, 1.86). Diabetes was not statistically significantly associated with the risk of death from leukaemia and cancers of the bladder, cervix, oesophagus, stomach and lung.
  
  
  
  Diabetes was associated with a 26% increased risk of death from any cancer in Asians. The pattern of associations with specific cancers suggests the need for better control (prevention, detection, management) of the growing epidemic of diabetes (as well as obesity), in order to reduce cancer mortality.
authors.affiliation: Department of Population Health, New York University School of Medicine, 650 First Avenue, Room 510, New York, NY, 10016, USA. yu.chen@nyumc.org.|Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, NY, 10987, USA. yu.chen@nyumc.org.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Population Health, New York University School of Medicine, 650 First Avenue, Room 510, New York, NY, 10016, USA.|Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, NY, 10987, USA.
authors.forename: Fen
authors.initials: F
authors.lastname: Wu
authors.affiliation: AXA Department of Health and Human Security, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.|Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
authors.forename: Eiko
authors.initials: E
authors.lastname: Saito
authors.affiliation: Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Yingsong
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Minkyo
authors.initials: M
authors.lastname: Song
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA.|Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA.
authors.forename: Hung N
authors.initials: HN
authors.lastname: Luu
authors.affiliation: Healis Sekhsaria Institute for Public Health, Navi Mumbai, India.
authors.forename: Prakash C
authors.initials: PC
authors.lastname: Gupta
authors.affiliation: Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
authors.forename: Norie
authors.initials: N
authors.lastname: Sawada
authors.affiliation: Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Tamakoshi
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Xiao-Ou
authors.initials: XO
authors.lastname: Shu
authors.affiliation: Duke-NUS Medical School Singapore, Singapore, Republic of Singapore.|Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore.
authors.forename: Woon-Puay
authors.initials: WP
authors.lastname: Koh
authors.affiliation: Shanghai Cancer Institute, Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors.forename: Yong-Bing
authors.initials: YB
authors.lastname: Xiang
authors.affiliation: Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.
authors.forename: Yasutake
authors.initials: Y
authors.lastname: Tomata
authors.affiliation: Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.
authors.forename: Kemmyo
authors.initials: K
authors.lastname: Sugiyama
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Sue K
authors.initials: SK
authors.lastname: Park
authors.affiliation: Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan.|Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Keitaro
authors.initials: K
authors.lastname: Matsuo
authors.affiliation: Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Chisato
authors.initials: C
authors.lastname: Nagata
authors.affiliation: Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Sugawara
authors.affiliation: Cancer Foundation of China, Beijing, People's Republic of China.
authors.forename: You-Lin
authors.initials: YL
authors.lastname: Qiao
authors.affiliation: School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan.|Big Data Research Centre, Fu-Jen Catholic University, Taipei, Taiwan.
authors.forename: San-Lin
authors.initials: SL
authors.lastname: You
authors.affiliation: University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.
authors.forename: Renwei
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Myung-Hee
authors.initials: MH
authors.lastname: Shin
authors.affiliation: Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
authors.forename: Wen-Harn
authors.initials: WH
authors.lastname: Pan
authors.affiliation: Healis Sekhsaria Institute for Public Health, Navi Mumbai, India.
authors.forename: Mangesh S
authors.initials: MS
authors.lastname: Pednekar
authors.affiliation: Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Tsugane
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Hui
authors.initials: H
authors.lastname: Cai
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.|Division of Cancer Control and Population Science, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Yuan
authors.affiliation: Shanghai Cancer Institute, Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors.forename: Yu-Tang
authors.initials: YT
authors.lastname: Gao
authors.affiliation: Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tsuji
authors.affiliation: Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.
authors.forename: Seiki
authors.initials: S
authors.lastname: Kanemura
authors.affiliation: Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.|Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
authors.forename: Hidemi
authors.initials: H
authors.lastname: Ito
authors.affiliation: Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Wada
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Yoon-Ok
authors.initials: YO
authors.lastname: Ahn
authors.affiliation: Armed Forces Capital Hospital, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Keun-Young
authors.initials: KY
authors.lastname: Yoo
authors.affiliation: Department of Public Health Sciences, University of Chicago, Chicago, IL, USA.
authors.forename: Habibul
authors.initials: H
authors.lastname: Ahsan
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore.
authors.forename: Kee Seng
authors.initials: KS
authors.lastname: Chia
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.affiliation: AXA Department of Health and Human Security, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.|Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
authors.forename: Manami
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea.|Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea.|Cancer Research Institute, Seoul National University, Seoul, South Korea.
authors.forename: Daehee
authors.initials: D
authors.lastname: Kang
authors.affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Centre for Public Health Research, Massey University, Wellington, New Zealand.|Department of Epidemiology, University of Washington, Seattle, WA, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Potter
mesh_terms: D000368:Aged; D001208:Asia; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality* / Q000503:physiopathology*; D015444:Exercise; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000503:physiopathology*; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires
keywords: Asia Cohort Consortium; Asians; Cancer mortality; Meta-analysis; Type 2 diabetes