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Diabetes Mellitus Increases the Risk of Bladder Cancer: An Updated Meta-analysis

  • Yang, Xiao-Qing (Tianjin Institute of Urology, Second Hospital of Tianjin Medical University) ;
  • Xu, Chen (Department of Colorectal Surgery, Nankai University Affiliated Hospital) ;
  • Sun, Yan (Tianjin Institute of Urology, Second Hospital of Tianjin Medical University) ;
  • Han, Rui-Fa (Tianjin Institute of Urology, Second Hospital of Tianjin Medical University)
  • Published : 2013.04.30

Abstract

Purpose: Studies have indicated that diabetes mellitus (DM) is a risk factor for bladder cancer; however, not all evidence supports this conclusion. The aim of this meta-analysis was to collate and evaluate all primary observational studies investigating the risk of bladder cancer associated with DM. Methods: The PubMed and Google Scholar databases were searched to identify studies that estimated the association of DM and bladder cancer. Summary effect estimates were derived using a random-effects meta-analysis model. Results: A total of 23 studies (8 case-control studies, 15 cohort studies) including 643,683 DM and 4,819,656 non-DM cases were identified. Analysis of all studies showed that DM was associated with an increased risk of bladder cancer compared with non-DM overall (OR=1.68, 95% CI 1.32-2.13). Analysis of subgroups demonstrated this to be the case in both case-control studies (OR=1.59, 95% CI 1.28-1.97, $I^2$=58%) and cohort studies (RR=1.70, 95% CI 1.23-2.33, $I^2$=96%). There was no gender difference in DM-associated bladder cancer risk. Bladder cancer risk was increased in Asia and the North America region, but not in Europe. Furthermore, DM-associated bladder cancer risk was obviously higher in Asia than North America and Europe or in those with Caucasian ethnicity. With extension of follow-up time, the bladder cancer risk was not increased for the patients with DM. Conclusions: This meta-analysis provided further evidence supporting theDM association with a significantly higher risk of bladder cancer obtained from observational studies.

References

  1. Coughlin SS, Calle EE, Teras LR, et al (2004). Diabetes mellitus as a predictor of cancer mortality in a large cohort of US adults. Am J Epidemiol, 159, 1160-7. https://doi.org/10.1093/aje/kwh161
  2. Giovannucci E, Harlan DM, Archer MC, et al (2010). Diabetes and cancer: a consensus report. Diabetes Care, 33, 1674-85. https://doi.org/10.2337/dc10-0666
  3. Inoue M, Iwasaki M, Otani T, et al (2006). Diabetes mellitus and the risk of cancer results from a Large-Scale Population-Based Cohort Study in Japan. Arch Intern Med, 166, 1871-7. https://doi.org/10.1001/archinte.166.17.1871
  4. Jee SH, Ohrr H, Sull JW, et al (2005). Fasting Serum Glucose Level and Cancer Risk in Korean Men and Women. JAMA, 293, 2.
  5. Jemal A, Siegel R, Ward E, et al (2008). Cancer Statistics, 2008. CA Cancer J Clin, 58, 71-96. https://doi.org/10.3322/CA.2007.0010
  6. Kantor AF, Hartge P, Hoover RN, et al (1984). Urinary tract infection and risk of bladder cancer. Am J Epidemiol, 119, 510-5.
  7. Adami HO, McLaughlin J, Ekbom A, et al (1991). Cancer risk in patients diabetes mellitus. Cancer Causes and Control, 2, 307-14. https://doi.org/10.1007/BF00051670
  8. Attner B, Landin-Olsson M, Lithman T, et al (2012). Cancer among patients with diabetes, obesity and abnormal blood lipids: a population-based register study in Sweden. Cancer Causes Control, 23, 769-7. https://doi.org/10.1007/s10552-012-9946-5
  9. Kessler II (1970). Cancer mortality among diabetics. J Natl Cancer Inst, 44, 673-86.
  10. Kravchick S, Gal R, Cytron S, et al (2001). Increased incidence of diabetes mellitus in the patients with transitional cell carcinoma of urinary bladder. Pathol Oncol Res, 7, 56-9. https://doi.org/10.1007/BF03032606
  11. La Vecchia C, Negri E, Franceschi S, et al (1994). A case-control study of diabetes mellitus and cancer risk. Br J Cancer, 70, 950-3. https://doi.org/10.1038/bjc.1994.427
  12. Larssona SC, Andersson SO, Johansson JE, et al (2008). Diabetes mellitus, body size and bladder cancer risk in a prospective study of Swedish men. Eur J Cancer, 44, 2655-60. https://doi.org/10.1016/j.ejca.2008.07.012
  13. Larsson SC, Orsini N, Brismar K, Wolk A (2006). Diabetes mellitus and risk of bladder cancer: a meta-analysis. Diabetologia, 49, 2819-23. https://doi.org/10.1007/s00125-006-0468-0
  14. Li C, Balluz LS, Ford ES, et al (2011). Association between diagnosed diabetes and self-reported cancer among U.S. adults: findings from the 2009 Behavioral Risk Factor Surveillance System. Diabetes Care, 34, 1365-8. https://doi.org/10.2337/dc11-0020
  15. MacKenzie T, Zens MS, Ferrara A, et al (2011). Diabetes and risk of bladder cancer: evidence from a case-control study in New England. Cancer, 117, 1552-6. https://doi.org/10.1002/cncr.25641
  16. Newton CC, Gapstur SM, Campbell PT, et al (2013). Type 2 diabetes mellitus, insulin-use and risk of bladder cancer in a large cohort study. Int J Cancer, 132, 2186-91. https://doi.org/10.1002/ijc.27878
  17. Ng Y, Husain I, Waterfall N (2003). Diabetes mellitus and bladder cancer-an epidemiological relationship? Pathol Oncol Res, 9, 30-1. https://doi.org/10.1007/BF03033711
  18. Nicolucci A (2010). Epidemiological aspects of neoplasms in diabetes. Acta Diabetol, 47, 87-95. https://doi.org/10.1007/s00592-010-0187-3
  19. O'Mara BA, Byers T, Schoenfeld E, et al (1985). Diabetes mellitus and cancer risk: a multisite case-control study. J Chronic Dis, 38, 435-41. https://doi.org/10.1016/0021-9681(85)90139-0
  20. Parkin MD, Bray F, Ferlay J, et al (2005). Global cancer statistics, 2002. CA Cancer J Clin, 55, 74-108. https://doi.org/10.3322/canjclin.55.2.74
  21. Prizment AE, Anderson KE, Yuan JM, et al (2013). Diabetes and risk of bladder cancer among postmenopausal women in the Iowa women's health study. Cancer Causes Control, 24, 603-8. https://doi.org/10.1007/s10552-012-0143-3
  22. Ragozzino M, Melton LJ 3rd, Chu CP, et al (1982). Subsequent cancer risk in the incidence cohort of Rochester, Minnesota, residents with diabetes mellitus. J Chronic Dis, 35, 13-9. https://doi.org/10.1016/0021-9681(82)90025-X
  23. Risch HA, Burch JD, Miller AB, et al (1988). Dietary factors and the incidence of cancer of the urinary bladder. Am J Epidemiol, 127, 1179-91.
  24. Rousseau MC, Parent ME, Pollak MN, et al (2006). Diabetes mellitus and cancer risk in a population-based case-control study among men from Montreal, Canada. Int J Cancer, 118, 2105-9. https://doi.org/10.1002/ijc.21600
  25. Swerdlow AJ, Laing SP, Qiao Z, et al (2005). Cancer incidence and mortality in patients with insulin-treated diabetes: a UK cohort study. Br J Cancer, 92, 2070-5. https://doi.org/10.1038/sj.bjc.6602611
  26. Tripathi A, Folsom AR, Anderson KE (2002). Risk factors for urinary bladder carcinoma in postmenopausal women. The Iowa Women's Health Study. Cancer, 95, 2316-23. https://doi.org/10.1002/cncr.10975
  27. Tseng CH (2011). Diabetes and risk of bladder cancer: a study using the National Health Insurance database in Taiwan. Diabetologia, 54, 2009-15. https://doi.org/10.1007/s00125-011-2171-z
  28. Verlato G, Zoppini G, Bonora E, et al (2003). Mortality from site-specific malignancies in type 2 diabetic patients from Verona. Diabetes Care, 26, 1047-951. https://doi.org/10.2337/diacare.26.4.1047
  29. Wild S, Roglic G, Green A, et al (2000). Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care, 27, 1047-53.
  30. Wideroff L, Gridley G, Mellemkjaer L, et al (1997). Cancer incidence in a population-based cohort of patients hospitalized with diabetes mellitus in Denmark. J Natl Cancer Inst, 89, 1360-5. https://doi.org/10.1093/jnci/89.18.1360
  31. Zendehdel K, Nyren O, Ostenson CG, et al (2003). Cancer incidence in patients with type 1 diabetes mellitus: a population-based cohort study in Sweden. J Natl Cancer Inst, 95, 1797-800. https://doi.org/10.1093/jnci/djg105
  32. Zhang PH, Zhong-Wen Chen, Duo Lv, et al (2012). Increased risk of cancer in patients with type 2 diabetes mellitus: A retrospective cohort study in China. BMC Public Health, 12, 567. https://doi.org/10.1186/1471-2458-12-567

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