- Volume 16 Issue 16
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Prevalence of Cancers of Female Organs among Patients with Diabetes Type 2 in Kelantan, Malaysia: Observations over an 11 Year Period and Strategies to Reduce the Incidence
- Jalil, Nur Asyilla Che (Department of Pathology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia) ;
- Zin, Anani Aila Mat (Department of Pathology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia) ;
- Othman, Nor Hayati (Department of Pathology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia)
- Published : 2015.11.04
Introduction: Kelantan is one of the states in Malaysia which has a high prevalence of type 2 diabetes (DM2). Other than with endometrial carcinoma, the association of DM2 with particular female cancers is not known. Objective: To determine the proportion of breast, cervical, ovarian and endometrial cancers among females with DM2 diagnosed in Hospital Universiti Sains Malaysia (HUSM) over an 11 year period. Materials and Methods: All histologically confirmed cases of breast, endometrial, cervical and ovarian carcinomas admitted to the Hospital were included in the study. The patient diabetic status was traced from the hospital medical records. Results: There was a total of 860 cases of breast, cervical, ovarian and endometrial carcinomas over this period. Breast carcinoma was the commonest, accounting for 437/860 (50.8%) followed by cervix, 159/860 (18.5%), ovarian, 143/860 (16.6%) and endometrial carcinomas, 121/860 (14.1%). Out of these, 228/860 (26.5%) were confirmed diabetics. Endometrial carcinoma patients showed the highest proportion being diabetics, 42.1% (51/121), followed by ovarian cancer, 25.9% (37/143), breast carcinoma, 23.6% (103/437) and cervical cancer 23.3% (37/159). Conclusions: There is a significant proportion of DM2 among women with these four cancers, endometrial carcinoma being the highest followed by ovarian, breast and cervical carcinoma. The rising trend of these four cancers is in tandem with an increasing trend of DM2 in the community. In populations where diabetes is prevalent, screening for epithelial cancers should be rigourous. Diabetic clinics should include screening for these cancers among their female patients and gynecology clinics should screen the women they treat for their diabetes status.
Female cancers;diabetes type 2;Kelantan;increasing trend
- Adler AI, Weiss NS, Kamb ML, et al (1996). Is diabetes mellitus a risk factor for ovarian cancer? A case-control study in Utah and Washington (United States). Cancer Causes Control, 7, 475-8. https://doi.org/10.1007/BF00052674
- Antunes CM, Stolley PD, Rosenshein NB, et al (1979). Endometrial cancer and estrogen use: Report of a large case-control study. New England J Medicine, 300, 9-13. https://doi.org/10.1056/NEJM197901043000103
- Bakhru A, Buckanovich RJ, Griggs JJ (2011). The impact of diabetes on survival in women with ovarian cancer. Gynecol Oncol, 121, 106-11. https://doi.org/10.1016/j.ygyno.2010.12.329
- Breen N & Kessler L (1994). Changes in the use of screening mammography: evidence from the 1987 and 1990 National Health Interview Surveys. Am J Public Health, 84, 62-67. https://doi.org/10.2105/AJPH.84.1.62
- Calle E E, Rodriguez C, Walker-Thurmond K, et al (2003). Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med, 348, 1625-38. https://doi.org/10.1056/NEJMoa021423
- Dahlui M, Ramli S, Bulgiba AM (2011). Breast cancer prevention and control programs in Malaysia. Asian Pac J Cancer Prev, 12, 1631-4.
- Friberg E, Mantzoros CS, Wolk A (2007). Diabetes and risk of endometrial cancer: a population-based prospective cohort study. Cancer Epidemiol Biomarkers Prev, 16, 276-80. https://doi.org/10.1158/1055-9965.EPI-06-0751
- Inoue M, Iwasaki M, Otani T, et al (2006a). Diabetes mellitus and the risk of cancer: results from a large-scale populationbased cohort study in Japan. Arch Intern Med, 166, 1871-7. https://doi.org/10.1001/archinte.166.17.1871
- Inoue M, Iwasaki M, Otani T, et al (2006b). Diabetes mellitus and the risk of cancer: results from a large-scale populationbased cohort study in Japan. Arch Intern Med, 166, 1871. https://doi.org/10.1001/archinte.166.17.1871
- Jan Mohamed HJ, Mitra AK, Zainuddin LR, et al (2013). Women are at a higher risk of metabolic syndrome in rural Malaysia. Women Health, 53, 335-48. https://doi.org/10.1080/03630242.2013.788120
- Kiefe CI, Funkhouser E, Fouad MN, et al (1998). Chronic disease as a barrier to breast and cervical cancer screening. J Gen Intern Med, 13, 357-65. https://doi.org/10.1046/j.1525-1497.1998.00115.x
- Kulie T, Slattengren A, Redmer J, et al (2011). Obesity and women’s health: an evidence-based review. J Am Board Fam Med, 24, 75-85. https://doi.org/10.3122/jabfm.2011.01.100076
- Kumar V, Abbas AK, Aster JC (2012) Robbins basic pathology, Elsevier Health Sciences.
- Lindemann K, Vatten LJ, Ellstrom-Engh M, et al (2008). Body mass, diabetes and smoking, and endometrial cancer risk: a follow-up study. Br J Cancer, 98, 1582-5. https://doi.org/10.1038/sj.bjc.6604313
- Mafauzy M (2006). Diabetes mellitus in Malaysia. Med J Malaysia, 61, 397-8.
- Mafauzy M, Mokhtar N, Mohamad WB, et al (1999). Diabetes mellitus and associated cardiovascular risk factors in northeast Malaysia. Asia Pac J Public Health, 11, 16-9. https://doi.org/10.1177/101053959901100104
- Michels KB, Solomon CG, Hu FB, et al (2003). Type 2 diabetes and subsequent incidence of breast cancer in the Nurses’ Health Study. Diabetes Care, 26, 1752-8. https://doi.org/10.2337/diacare.26.6.1752
- Othman NH, Devi BC, Halimah Y (2009). Cervical cancer screening: patients understanding in major hospitals in Malaysia. Asian Pac J Cancer Prev, 10, 569-74.
- Othman NH, Mohamad Zaki FH (2014). Self-collection tools for routine cervical cancer screening: a review. Asian Pac J Cancer Prev, 15, 8563-9. https://doi.org/10.7314/APJCP.2014.15.20.8563
- Othman NH, Nor ZM, Biswal BM (2008). Is Kelantan joining the global cancer epidemic?--experience from hospital Universiti Sains Malaysia; 1987-2007. Asian Pac J Cancer Prev, 9, 473-8.
- Othman NH, Rebolj M (2009). Challenges to cervical screening in a developing country: The case of Malaysia. Asian Pac J Cancer Prev, 10, 747-52.
- Othman N H & Zin AA (2008). Association of colorectal carcinoma with metabolic diseases; experience with 138 cases from Kelantan, Malaysia. Asian Pac J Cancer Prev, 9, 747-51.
- Pollak M (2008). Insulin and insulin-like growth factor signalling in neoplasia. Nat Rev Cancer, 8, 915-28. https://doi.org/10.1038/nrc2536
- Salazar-Martinez E, Lazcano-Ponce EC, Lira-Lira GG, et al (2000). Case-control study of diabetes, obesity, physical activity and risk of endometrial cancer among Mexican women. Cancer Causes & Control, 11, 707-711. https://doi.org/10.1023/A:1008913619107
- Shah MM, Erickson BK, Matin T, et al (2014). Diabetes mellitus and ovarian cancer: more complex than just increasing risk. Gynecol Oncol, 135, 273-7. https://doi.org/10.1016/j.ygyno.2014.09.004
- 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
- Tsilidis KK, Kasimis JC, Lopez DS, et al (2015). Type 2 diabetes and cancer: umbrella review of meta-analyses of observational studies. BMJ, 350, 7607. https://doi.org/10.1136/bmj.g7607
- Vigneri P, Frasca F, Sciacca L, et al (2009). Diabetes and cancer. Endocr Relat Cancer, 16, 1103-23. https://doi.org/10.1677/ERC-09-0087
- Weiderpass E, Ye W, Vainio H, et al (2002). Diabetes mellitus and ovarian cancer (Sweden). Cancer Causes Control, 13, 759-64. https://doi.org/10.1023/A:1020271000069
- Yip CH, Taib NA (2014). Breast health in developing countries. Climacteric, 17, 54-9. https://doi.org/10.3109/13697137.2014.947255
- Zaini A (2000). Where is Malaysia in the midst of the Asian epidemic of diabetes mellitus? Diabetes Res Clin Pract, 50, 23-8.
- Zhou Y, Zhang X, Gu C, et al (2015). Diabetes mellitus is associated with breast cancer: systematic review, metaanalysis, and in silico reproduction. Panminerva Med, 57, 101-8.