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Diabetes mellitus, insulin treatment, diabetes duration, and risk of biliary tract cancer and hepatocellular carcinoma in a European cohort

Schlesinger, S.; Aleksandrova, K.; Pischon, T.; Jenab, M.; Fedirko, V.; Trepo, E.; Overvad, K.; Roswall, N.; Tjonneland, A. and Boutron-Ruault, M. C., et al. (2013) In Annals of Oncology 24(9). p.2449-2455
Abstract
Evidence on associations between self-reported diabetes mellitus, diabetes duration, age at diabetes diagnosis, insulin treatment, and risk of biliary tract cancer (BTC) and hepatocellular carcinoma (HCC), independent of general and abdominal obesity is scarce. We conducted a prospective analysis in the EPIC-cohort study among 363 426 participants with self-reported diabetes data. Multivariable adjusted relative risks and 95% confidence intervals were estimated from Cox regression models. In a nested case-control subset, analyses were carried out in HCV/HBV-negative individuals. During 8.5 years of follow-up, 204 BTC cases [including 75 gallbladder cancer (GBC) cases], and 176 HCC cases were identified. Independent of body mass index and... (More)
Evidence on associations between self-reported diabetes mellitus, diabetes duration, age at diabetes diagnosis, insulin treatment, and risk of biliary tract cancer (BTC) and hepatocellular carcinoma (HCC), independent of general and abdominal obesity is scarce. We conducted a prospective analysis in the EPIC-cohort study among 363 426 participants with self-reported diabetes data. Multivariable adjusted relative risks and 95% confidence intervals were estimated from Cox regression models. In a nested case-control subset, analyses were carried out in HCV/HBV-negative individuals. During 8.5 years of follow-up, 204 BTC cases [including 75 gallbladder cancer (GBC) cases], and 176 HCC cases were identified. Independent of body mass index and waist-to-height ratio diabetes status was associated with higher risk of BTC and HCC [1.77 (1.00-3.13) and 2.17 (1.36-3.47)]. For BTC, the risk seemed to be higher in participants with shorter diabetes duration and those not treated with insulin. Regarding cancer subsites, diabetes was only associated with GBC [2.72 (1.17-6.31)]. The risk for HCC was particularly higher in participants treated with insulin. The results were not appreciably different in HCV/HBV-negative individuals. This study supports the hypothesis that diabetes is a risk factor for BTC (particularly GBC) and HCC. Further research is required to establish whether diabetes treatment or duration is associated with these cancers. (Less)
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@article{0e3f63e4-5b68-4eec-bf7e-0f6c20b8b156,
  abstract     = {Evidence on associations between self-reported diabetes mellitus, diabetes duration, age at diabetes diagnosis, insulin treatment, and risk of biliary tract cancer (BTC) and hepatocellular carcinoma (HCC), independent of general and abdominal obesity is scarce. We conducted a prospective analysis in the EPIC-cohort study among 363 426 participants with self-reported diabetes data. Multivariable adjusted relative risks and 95% confidence intervals were estimated from Cox regression models. In a nested case-control subset, analyses were carried out in HCV/HBV-negative individuals. During 8.5 years of follow-up, 204 BTC cases [including 75 gallbladder cancer (GBC) cases], and 176 HCC cases were identified. Independent of body mass index and waist-to-height ratio diabetes status was associated with higher risk of BTC and HCC [1.77 (1.00-3.13) and 2.17 (1.36-3.47)]. For BTC, the risk seemed to be higher in participants with shorter diabetes duration and those not treated with insulin. Regarding cancer subsites, diabetes was only associated with GBC [2.72 (1.17-6.31)]. The risk for HCC was particularly higher in participants treated with insulin. The results were not appreciably different in HCV/HBV-negative individuals. This study supports the hypothesis that diabetes is a risk factor for BTC (particularly GBC) and HCC. Further research is required to establish whether diabetes treatment or duration is associated with these cancers.},
  author       = {Schlesinger, S. and Aleksandrova, K. and Pischon, T. and Jenab, M. and Fedirko, V. and Trepo, E. and Overvad, K. and Roswall, N. and Tjonneland, A. and Boutron-Ruault, M. C. and Fagherazzi, G. and Racine, A. and Kaaks, R. and Grote, V. A. and Boeing, H. and Trichopoulou, A. and Pantzalis, M. and Kritikou, M. and Mattiello, A. and Sieri, S. and Sacerdote, C. and Palli, D. and Tumino, R. and Peeters, P. H. and Bueno-de-Mesquita, H. B. and Weiderpass, E. and Quiros, J. R. and Zamora-Ros, R. and Sanchez, M. J. and Arriola, L. and Ardanaz, E. and Tormo, M. J. and Nilsson, Peter and Lindkvist, B. and Sund, M. and Rolandsson, O. and Khaw, K. T. and Wareham, N. and Travis, R. C. and Riboli, E. and Noethlings, U.},
  issn         = {1569-8041},
  keyword      = {biliary tract neoplasms,diabetes duration,diabetes mellitus,gallbladder neoplasms,hepatocellular carcinoma,insulin treatment},
  language     = {eng},
  number       = {9},
  pages        = {2449--2455},
  publisher    = {Oxford University Press},
  series       = {Annals of Oncology},
  title        = {Diabetes mellitus, insulin treatment, diabetes duration, and risk of biliary tract cancer and hepatocellular carcinoma in a European cohort},
  url          = {http://dx.doi.org/10.1093/annonc/mdt204},
  volume       = {24},
  year         = {2013},
}