Abstract

OBJECTIVE
Diabetes is a major predictor of death from heart disease and stroke; its impact on nonvascular mortality, including specific cancers, is less understood. We examined the association of diabetes with cause-specific mortality, including deaths from specific cancers.
RESEARCH DESIGN AND METHODS
A prospective cohort of 1,053,831 U.S. adults, without cancer at baseline, enrolled in the Cancer Prevention Study-II in 1982 and was followed for mortality until December 2008. At baseline, participants completed a self-administered questionnaire that included information on diabetes, smoking, physical activity, height, and weight. Multivariable-adjusted relative risks (RRs) (95% CI) were estimated using Cox proportional hazards regression.
RESULTS
During 26 years of follow-up, 243,051 men and 222,109 women died. In multivariable models that controlled for age, BMI, and other variables, diabetes was associated with higher risk of all-cause mortality (women RR 1.90 [95% CI 1.87-1.93]; men 1.73 [1.70-1.75]). Among women, diabetes was associated with higher risk of death from cancers of the liver (1.40 [1.05-1.86]), pancreas (1.31 [1.14-1.51]), endometrium (1.33 [1.08-1.65]), colon (1.18 [1.04-1.33]), and breast (1.16 [1.03-1.29]). Among men, diabetes was associated with risk of death from cancers of the breast (4.20 [2.20-8.04]), liver (2.26 [1.89-2.70]), oral cavity and pharynx (1.44 [1.07-1.94]), pancreas (1.40 [1.23-1.59]), bladder (1.22 [1.01-1.47]), colon (1.15 [1.03-1.29]), and (inversely) prostate (0.88 [0.79-0.97]). Diabetes was also associated with higher risks of death involving the circulatory system, respiratory system, digestive system, genitourinary system, and external causes/accidental deaths.
CONCLUSIONS
Diabetes is associated with higher risk of death for many diseases, including several specific forms of cancer.

Links

Publisher Full Text

Authors

Campbell PT, Newton CC, Patel AV, Jacobs EJ, Gapstur SM

Institution

American Cancer Society National Home Office, Atlanta, GA, USA. peter.campbell@cancer.org

Source

Diabetes care 35:9 2012 Sep pg 1835-44

MeSH

Adult
Aged
Aged, 80 and over
Body Mass Index
Cardiovascular Diseases
Diabetes Mellitus
Humans
Middle Aged
Neoplasms
Prospective Studies
Questionnaires
Risk Factors

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22699290