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Diabetes and gastric cancer incidence and mortality in the Asia Cohort Consortium: A pooled analysis of more than a half million participants

Journal Article · · Journal of Diabetes
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  1. Department of Biomedical Sciences Seoul National University Graduate School Seoul Korea, Department of Preventive Medicine Seoul National University College of Medicine Seoul Korea
  2. Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda Maryland USA, Laboratory of Epidemiology and Population Sciences National Institute on Aging, National Institute of Health Baltimore Maryland USA
  3. Division of Prevention National Cancer Center Institute for Cancer Control Tokyo Japan
  4. Division of Prevention National Cancer Center Institute for Cancer Control Tokyo Japan, Research Center for Child Mental Development, Hamamatsu University School of Medicine Tokyo Japan
  5. Division of Prevention National Cancer Center Institute for Cancer Control Tokyo Japan, Hitotsubashi Institute for Advanced Study, Hitotsubashi University Tokyo Japan
  6. Institute for Global Health Policy Research, National Center for Global Health and Medicine Tokyo Japan
  7. Department of Preventive Medicine Seoul National University College of Medicine Seoul Korea
  8. Department of Preventive Medicine Seoul National University College of Medicine Seoul Korea, Integrated Major in Innovative Medical Science, Seoul National University Graduate School Seoul Korea
  9. Department of Population Health and Environmental Medicine NYU Grossman School of Medicine New York New York USA
  10. Healis – Sekhsaria Institute for Public Health Navi Mumbai India
  11. Division of Cohort Research National Cancer Center Institute for Cancer Control Tokyo Japan
  12. Department of Public Health Hokkaido University Faculty of Medicine Sapporo Japan
  13. Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center Vanderbilt‐Ingram Cancer Center Vanderbilt University Medical Center Nashville Tennessee USA
  14. Radiation Effects Research Foundation Hiroshima Japan
  15. Graduate School of Cancer Science and Policy, National Cancer Center Goyang Korea
  16. Department of Epidemiology and Preventive Medicine Gifu University Graduate School of Medicine Gifu Japan
  17. Department of Preventive Medicine, Division of Cancer Information and Control Aichi Cancer Center Research Institute Nagoya Japan, Division of Descriptive Cancer Epidemiology Nagoya University Graduate School of Medicine Nagoya Japan
  18. Department of Social and Preventive Medicine Sungkyunkwan University School of Medicine Seoul Korea
  19. Division of Cohort Research National Cancer Center Institute for Cancer Control Tokyo Japan, International University of Health and Welfare Graduate School Tokyo Japan
  20. Department of Epidemiology Shanghai Cancer Institute Shanghai China, Renji Hospital, Shanghai Jiaotong University School of Medicine Shanghai China
  21. Division of Cancer Epidemiology and Prevention Aichi Cancer Center Research Institute Nagoya Japan
  22. Department of Preventive Medicine Seoul National University College of Medicine Seoul Korea, Cancer Research Institute, Seoul National University Seoul Korea
  23. Department of Public Health Sciences University of Chicago Chicago Illinois USA
  24. Stony Brook Cancer Center, Stony Brook University Stony Brook New York USA, Department of Medical and Surgical Sciences University of Bologna Bologna Italy
  25. Saw Swee Hock School of Public Health, National University of Singapore Singapore Singapore
  26. Division of Cancer Epidemiology and Prevention Aichi Cancer Center Research Institute Nagoya Japan, Department of Cancer Epidemiology Nagoya University Graduate School of Medicine Nagoya Nagoya Japan
  27. School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
  28. Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda Maryland USA
+ Show Author Affiliations
Abstract Background

Evidence suggests a possible link between diabetes and gastric cancer risk, but the findings remain inconclusive, with limited studies in the Asian population. We aimed to assess the impact of diabetes and diabetes duration on the development of gastric cancer overall, by anatomical and histological subtypes.

Methods

A pooled analysis was conducted using 12 prospective studies included in the Asia Cohort Consortium. Among 558 981 participants (median age 52), after a median follow‐up of 14.9 years and 10.5 years, 8556 incident primary gastric cancers and 8058 gastric cancer deaths occurred, respectively. Cox proportional hazard regression models were used to estimate study‐specific hazard ratios (HRs) and 95% confidence intervals (CIs) and pooled using random‐effects meta‐analyses.

Results

Diabetes was associated with an increased incidence of overall gastric cancer (HR 1.15, 95% CI 1.06–1.25). The risk association did not differ significantly by sex (women vs men: HR 1.31, 95% CI 1.07–1.60 vs 1.12, 1.01–1.23), anatomical subsites (noncardia vs cardia: 1.14, 1.02–1.28 vs 1.17, 0.77–1.78) and histological subtypes (intestinal vs diffuse: 1.22, 1.02–1.46 vs 1.00, 0.62–1.61). Gastric cancer risk increased significantly during the first decade following diabetes diagnosis (HR 4.70, 95% CI 3.77–5.86), and decreased with time (nonlinear p  < .01). Positive associations between diabetes and gastric cancer mortality were observed (HR 1.15, 95% CI 1.03–1.28) but attenuated after a 2‐year time lag.

Conclusion

Diabetes was associated with an increased gastric cancer incidence regardless of sex, anatomical subsite, or subtypes of gastric cancer. The risk of gastric cancer was particularly high during the first decade following diabetes diagnosis.

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Research Organization:
Vanderbilt University Medical Center, Nashville, TN (United States)
Sponsoring Organization:
USDOE
OSTI ID:
2350990
Alternate ID(s):
OSTI ID: 2470345
Journal Information:
Journal of Diabetes, Journal Name: Journal of Diabetes Journal Issue: 6 Vol. 16; ISSN 1753-0393
Publisher:
Wiley-BlackwellCopyright Statement
Country of Publication:
Australia
Language:
English

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Related Subjects

60 APPLIED LIFE SCIENCES
Asia
diabetes
gastric cancer
incidence
mortality
prospective studies