Association between Gastroenterological Malignancy and Diabetes Mellitus and Anti-Diabetic Therapy: A Nationwide, Population-Based Cohort Study
The relationship between diabetes mellitus (DM) and cancer incidence has been evaluated in limited kinds of cancer. The effect of anti-diabetic therapy (ADT) on carcinogenesis among diabetic patients is also unclear. Using population-based representative insurance claims data in Taiwan, 36,270 DM pa...
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| Veröffentlicht in: | PloS one 2015-05, Vol.10 (5), p.e0125421 |
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| creator | Lin, Chien-Ming Huang, Hui-Ling Chu, Fang-Ying Fan, Hueng-Chuen Chen, Hung-An Chu, Der-Ming Wu, Li-Wei Wang, Chung-Ching Chen, Wei-Liang Lin, Shih-Hua Ho, Shinn-Ying |
| description | The relationship between diabetes mellitus (DM) and cancer incidence has been evaluated in limited kinds of cancer. The effect of anti-diabetic therapy (ADT) on carcinogenesis among diabetic patients is also unclear.
Using population-based representative insurance claims data in Taiwan, 36,270 DM patients and 145,080 comparison subjects without DM were identified from claims from 2005 to 2010. The association between the top ten leading causes of cancer-related death in Taiwan and DM was evaluated. Whether ADT altered the risk of developing cancer was also investigated.
Incidence of cancer at any site was significantly higher in patients with DM than in those without (p |
| doi_str_mv | 10.1371/journal.pone.0125421 |
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Using population-based representative insurance claims data in Taiwan, 36,270 DM patients and 145,080 comparison subjects without DM were identified from claims from 2005 to 2010. The association between the top ten leading causes of cancer-related death in Taiwan and DM was evaluated. Whether ADT altered the risk of developing cancer was also investigated.
Incidence of cancer at any site was significantly higher in patients with DM than in those without (p<0.001). The risk of carcinogenesis imparted by DM was greatest in gastroenterological malignancies (liver, pancreas, and colorectal cancer) as well as lung, breast and oral cancer (p<0.001). Among the oral types of ADT, metformin decreased the risk of lung and liver cancer, but had less effect on reducing the risk of colorectal cancer. α-glucosidase inhibitor decreased the risk of developing liver, colorectal, and breast cancer. Apart from intermediate-acting insulin, rapid-acting, long-acting, and combination insulin treatment significantly reduced the overall cancer risk among all DM patients. In subgroup analysis, long-acting insulin treatment significantly decreased the risk of lung, liver, and colorectal cancer.
Our results supported the notion that pre-existing DM increases the incidence of gastroenterological cancer. ADT, especially metformin, α-glucosidase inhibitor, and long-acting insulin treatment, may protect patients with DM against these malignancies. It is crucial that oncologists should closely collaborate with endocrinologists to provide an optimal cancer-specific therapy and diabetic treatment to patients simultaneously with cancer and DM.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0125421</identifier><identifier>PMID: 25978841</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Analysis ; Antidiabetics ; Bioinformatics ; Biology ; Breast cancer ; Cancer ; Carcinogenesis ; Carcinogens ; Care and treatment ; Cell cycle ; Cohort analysis ; Cohort Studies ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - epidemiology ; Colorectal Neoplasms - etiology ; Complications and side effects ; Development and progression ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus - drug therapy ; Diabetes Mellitus - epidemiology ; Female ; Gender ; Glucosidase ; Glycoside Hydrolase Inhibitors - adverse effects ; Health insurance ; Health risk assessment ; Health risks ; Hospitals ; Humans ; Hyperglycemia ; Hypoglycemic Agents - adverse effects ; Incidence ; Inhibitors ; Insulin ; Insulin, Long-Acting - adverse effects ; Liver ; Liver cancer ; Liver Neoplasms - epidemiology ; Liver Neoplasms - etiology ; Lung cancer ; Male ; Malignancy ; Medicine ; Metformin ; Metformin - adverse effects ; Middle Aged ; Obesity ; Oral cancer ; Pancreas ; Pancreatic cancer ; Pancreatic Neoplasms - epidemiology ; Pancreatic Neoplasms - etiology ; Patients ; Pediatrics ; Population ; Population studies ; Population-based studies ; Retrospective Studies ; Review boards ; Risk ; Risk reduction ; Studies ; Systematic review ; Taiwan ; Therapy ; Young Adult ; α-Glucosidase</subject><ispartof>PloS one, 2015-05, Vol.10 (5), p.e0125421</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Lin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Lin et al 2015 Lin et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-baf71484a07e438973ada835da1581eed7c565284d4614970a5334465960616a3</citedby><cites>FETCH-LOGICAL-c758t-baf71484a07e438973ada835da1581eed7c565284d4614970a5334465960616a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4433253/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4433253/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25978841$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Akiba, Suminori</contributor><creatorcontrib>Lin, Chien-Ming</creatorcontrib><creatorcontrib>Huang, Hui-Ling</creatorcontrib><creatorcontrib>Chu, Fang-Ying</creatorcontrib><creatorcontrib>Fan, Hueng-Chuen</creatorcontrib><creatorcontrib>Chen, Hung-An</creatorcontrib><creatorcontrib>Chu, Der-Ming</creatorcontrib><creatorcontrib>Wu, Li-Wei</creatorcontrib><creatorcontrib>Wang, Chung-Ching</creatorcontrib><creatorcontrib>Chen, Wei-Liang</creatorcontrib><creatorcontrib>Lin, Shih-Hua</creatorcontrib><creatorcontrib>Ho, Shinn-Ying</creatorcontrib><title>Association between Gastroenterological Malignancy and Diabetes Mellitus and Anti-Diabetic Therapy: A Nationwide, Population-Based Cohort Study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The relationship between diabetes mellitus (DM) and cancer incidence has been evaluated in limited kinds of cancer. The effect of anti-diabetic therapy (ADT) on carcinogenesis among diabetic patients is also unclear.
Using population-based representative insurance claims data in Taiwan, 36,270 DM patients and 145,080 comparison subjects without DM were identified from claims from 2005 to 2010. The association between the top ten leading causes of cancer-related death in Taiwan and DM was evaluated. Whether ADT altered the risk of developing cancer was also investigated.
Incidence of cancer at any site was significantly higher in patients with DM than in those without (p<0.001). The risk of carcinogenesis imparted by DM was greatest in gastroenterological malignancies (liver, pancreas, and colorectal cancer) as well as lung, breast and oral cancer (p<0.001). Among the oral types of ADT, metformin decreased the risk of lung and liver cancer, but had less effect on reducing the risk of colorectal cancer. α-glucosidase inhibitor decreased the risk of developing liver, colorectal, and breast cancer. Apart from intermediate-acting insulin, rapid-acting, long-acting, and combination insulin treatment significantly reduced the overall cancer risk among all DM patients. In subgroup analysis, long-acting insulin treatment significantly decreased the risk of lung, liver, and colorectal cancer.
Our results supported the notion that pre-existing DM increases the incidence of gastroenterological cancer. ADT, especially metformin, α-glucosidase inhibitor, and long-acting insulin treatment, may protect patients with DM against these malignancies. It is crucial that oncologists should closely collaborate with endocrinologists to provide an optimal cancer-specific therapy and diabetic treatment to patients simultaneously with cancer and DM.</description><subject>Adult</subject><subject>Analysis</subject><subject>Antidiabetics</subject><subject>Bioinformatics</subject><subject>Biology</subject><subject>Breast cancer</subject><subject>Cancer</subject><subject>Carcinogenesis</subject><subject>Carcinogens</subject><subject>Care and treatment</subject><subject>Cell cycle</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - epidemiology</subject><subject>Colorectal Neoplasms - etiology</subject><subject>Complications and side effects</subject><subject>Development and progression</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus - drug therapy</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Female</subject><subject>Gender</subject><subject>Glucosidase</subject><subject>Glycoside Hydrolase Inhibitors - adverse effects</subject><subject>Health insurance</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hypoglycemic Agents - adverse effects</subject><subject>Incidence</subject><subject>Inhibitors</subject><subject>Insulin</subject><subject>Insulin, Long-Acting - adverse effects</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - epidemiology</subject><subject>Liver Neoplasms - etiology</subject><subject>Lung cancer</subject><subject>Male</subject><subject>Malignancy</subject><subject>Medicine</subject><subject>Metformin</subject><subject>Metformin - adverse effects</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Oral cancer</subject><subject>Pancreas</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - epidemiology</subject><subject>Pancreatic Neoplasms - etiology</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Population</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Retrospective Studies</subject><subject>Review boards</subject><subject>Risk</subject><subject>Risk reduction</subject><subject>Studies</subject><subject>Systematic review</subject><subject>Taiwan</subject><subject>Therapy</subject><subject>Young Adult</subject><subject>α-Glucosidase</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk9Fu0zAUhiMEYqPwBggiISEhkRLHduLsAqkUGJU2htjg1jqJndSVGxfbYfQpeGXcNpsWCSSUC8fH3_l9_OucKHqK0inCBXqzMr3tQE83ppPTFGWUZOhedIxKnCV5luL7d_6PokfOrdKUYpbnD6OjjJYFYwQdR79nzplagVemiyvpr6Xs4lNw3hrZeWmNNq2qQcfnoFXbQVdvY-hE_F5BoKWLz6XWyvduH511XiWHI1XHV0tpYbM9iWfx5_0F10rI1_EXs-n1fp-8AydFPDdLY3186XuxfRw9aEA7-WRYJ9G3jx-u5p-Ss4vTxXx2ltQFZT6poCkQYQTSQhLMygKDAIapAEQZklIUNc1pxoggOSJlkQLFmJCclnmaoxzwJHp-0N1o4_jgpeMoZygtSc7KQCwOhDCw4hur1mC33IDi-4CxLQcbnqklr6oyb2oGGImMFE1TFRQXQlZpE-rLCA1ab4fb-motRR2staBHouOTTi15a35yQjDOQumT6MUgYM2PXjr_j5IHqoVQleoaE8TqtXI1nxGcoZRgigI1_QsVPiHXqg7d1KgQHyW8GiUExstfvoXeOb64_Pr_7MX3MfvyDruUoP3SGd3vWsONQXIAa2ucs7K5dQ6lfDcMN27w3TDwYRhC2rO7rt8m3XQ__gN6_QVY</recordid><startdate>20150515</startdate><enddate>20150515</enddate><creator>Lin, Chien-Ming</creator><creator>Huang, Hui-Ling</creator><creator>Chu, Fang-Ying</creator><creator>Fan, Hueng-Chuen</creator><creator>Chen, Hung-An</creator><creator>Chu, Der-Ming</creator><creator>Wu, Li-Wei</creator><creator>Wang, Chung-Ching</creator><creator>Chen, Wei-Liang</creator><creator>Lin, Shih-Hua</creator><creator>Ho, Shinn-Ying</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150515</creationdate><title>Association between Gastroenterological Malignancy and Diabetes Mellitus and Anti-Diabetic Therapy: A Nationwide, Population-Based Cohort Study</title><author>Lin, Chien-Ming ; Huang, Hui-Ling ; Chu, Fang-Ying ; Fan, Hueng-Chuen ; Chen, Hung-An ; Chu, Der-Ming ; Wu, Li-Wei ; Wang, Chung-Ching ; Chen, Wei-Liang ; Lin, Shih-Hua ; Ho, Shinn-Ying</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-baf71484a07e438973ada835da1581eed7c565284d4614970a5334465960616a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Analysis</topic><topic>Antidiabetics</topic><topic>Bioinformatics</topic><topic>Biology</topic><topic>Breast cancer</topic><topic>Cancer</topic><topic>Carcinogenesis</topic><topic>Carcinogens</topic><topic>Care and treatment</topic><topic>Cell cycle</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Colorectal Neoplasms - epidemiology</topic><topic>Colorectal Neoplasms - etiology</topic><topic>Complications and side effects</topic><topic>Development and progression</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus - drug therapy</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Female</topic><topic>Gender</topic><topic>Glucosidase</topic><topic>Glycoside Hydrolase Inhibitors - adverse effects</topic><topic>Health insurance</topic><topic>Health risk assessment</topic><topic>Health risks</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>Hypoglycemic Agents - adverse effects</topic><topic>Incidence</topic><topic>Inhibitors</topic><topic>Insulin</topic><topic>Insulin, Long-Acting - adverse effects</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - epidemiology</topic><topic>Liver Neoplasms - etiology</topic><topic>Lung cancer</topic><topic>Male</topic><topic>Malignancy</topic><topic>Medicine</topic><topic>Metformin</topic><topic>Metformin - 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The effect of anti-diabetic therapy (ADT) on carcinogenesis among diabetic patients is also unclear.
Using population-based representative insurance claims data in Taiwan, 36,270 DM patients and 145,080 comparison subjects without DM were identified from claims from 2005 to 2010. The association between the top ten leading causes of cancer-related death in Taiwan and DM was evaluated. Whether ADT altered the risk of developing cancer was also investigated.
Incidence of cancer at any site was significantly higher in patients with DM than in those without (p<0.001). The risk of carcinogenesis imparted by DM was greatest in gastroenterological malignancies (liver, pancreas, and colorectal cancer) as well as lung, breast and oral cancer (p<0.001). Among the oral types of ADT, metformin decreased the risk of lung and liver cancer, but had less effect on reducing the risk of colorectal cancer. α-glucosidase inhibitor decreased the risk of developing liver, colorectal, and breast cancer. Apart from intermediate-acting insulin, rapid-acting, long-acting, and combination insulin treatment significantly reduced the overall cancer risk among all DM patients. In subgroup analysis, long-acting insulin treatment significantly decreased the risk of lung, liver, and colorectal cancer.
Our results supported the notion that pre-existing DM increases the incidence of gastroenterological cancer. ADT, especially metformin, α-glucosidase inhibitor, and long-acting insulin treatment, may protect patients with DM against these malignancies. It is crucial that oncologists should closely collaborate with endocrinologists to provide an optimal cancer-specific therapy and diabetic treatment to patients simultaneously with cancer and DM.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25978841</pmid><doi>10.1371/journal.pone.0125421</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2015-05, Vol.10 (5), p.e0125421 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1681094689 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Analysis Antidiabetics Bioinformatics Biology Breast cancer Cancer Carcinogenesis Carcinogens Care and treatment Cell cycle Cohort analysis Cohort Studies Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - epidemiology Colorectal Neoplasms - etiology Complications and side effects Development and progression Diabetes Diabetes mellitus Diabetes Mellitus - drug therapy Diabetes Mellitus - epidemiology Female Gender Glucosidase Glycoside Hydrolase Inhibitors - adverse effects Health insurance Health risk assessment Health risks Hospitals Humans Hyperglycemia Hypoglycemic Agents - adverse effects Incidence Inhibitors Insulin Insulin, Long-Acting - adverse effects Liver Liver cancer Liver Neoplasms - epidemiology Liver Neoplasms - etiology Lung cancer Male Malignancy Medicine Metformin Metformin - adverse effects Middle Aged Obesity Oral cancer Pancreas Pancreatic cancer Pancreatic Neoplasms - epidemiology Pancreatic Neoplasms - etiology Patients Pediatrics Population Population studies Population-based studies Retrospective Studies Review boards Risk Risk reduction Studies Systematic review Taiwan Therapy Young Adult α-Glucosidase |
| title | Association between Gastroenterological Malignancy and Diabetes Mellitus and Anti-Diabetic Therapy: A Nationwide, Population-Based Cohort Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T15%3A32%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Association%20between%20Gastroenterological%20Malignancy%20and%20Diabetes%20Mellitus%20and%20Anti-Diabetic%20Therapy:%20A%20Nationwide,%20Population-Based%20Cohort%20Study&rft.jtitle=PloS%20one&rft.au=Lin,%20Chien-Ming&rft.date=2015-05-15&rft.volume=10&rft.issue=5&rft.spage=e0125421&rft.pages=e0125421-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0125421&rft_dat=%3Cgale_plos_%3EA432104351%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1681094689&rft_id=info:pmid/25978841&rft_galeid=A432104351&rft_doaj_id=oai_doaj_org_article_bb96fc8a31d247ffb7537deb0fa07245&rfr_iscdi=true |