Cancer incidence in persons with type 1 diabetes: A 5-country study of 9,000 cancers in persons with type 1 diabetes

Diabetes and Cancer Research Consortium, Bendix Carstensen, Stephanie Read, Søren Friis, Reijo Sund, Ilmo Keskimaki, Ann-Marie Svensson, Rickard Ljung, Sarah Wild, Jan J Kerssens, Jessica Harding, Dianna Magliano, Soffia Gudbjörnsdottir

Research output: Contribution to journalArticlepeer-review

Abstract

Aims/hypothesis: An excess cancer incidence of 20-25% has been identified among persons with diabetes, most of whom have type 2 diabetes. We aimed to describe the association between type 1 diabetes and cancer incidence.
Methods: Persons with type 1 diabetes were identified from five nationwide diabetes registers: Australia (1997-2008), Denmark (1995-2014), Finland (1972-2012), Scotland (1995-2012) and Sweden (1987-2012). Linkage to national cancer registries provided numbers of incident cancers in people with type 1 diabetes and the general population. We used Poisson-models adjusting for age and start of follow-up to estimate rate ratios for cancer overall and for specific sites.
Results: A total of 9,149 cancers occurred among persons with type 1 diabetes during 3.9 million person-years. Median age at cancer diagnosis was 51.1 years (IQR: 43.5, 59.5). The RRs associated with type 1 diabetes for all cancers combined were 1.01 (95% CI: 0.98, 1.04) among men (M) and 1.07 (1.04, 1.10) among women (F). RRs were increased for cancer of the stomach (RR=1.23 [1.04, 1.46] (M), 1.78 [1.49, 2.13] (F)), liver (RR=2.00 [1.67, 2.40] (M), 1.55 [1.14, 2.10] (F)), pancreas (RR=1.53 [1.30, 1.79] (M) 1.25 [1.02,1.53] (F)), endometrium (RR=1.42 [1.27,1.58]) and kidney (RR=1.30 [1.12,1.49] (M), 1.47 [1.23, 1.77] (F)). Reduced RRs were found for cancer of the prostate (RR: 0.56 [0.51, 0.61]) and breast (RR=0.90 [0.85, 0.94]). Cancer incidence declined with increasing diabetes duration.
Conclusion: Type 1 diabetes was associated with differences in risk of several common cancers and the strength of the associations varied by duration of diabetes.
Original languageEnglish
JournalDiabetologia
Volume59
Issue number5
Early online date29 Feb 2016
DOIs
Publication statusPublished - May 2016

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