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

Journal Article · 16 May 2024 · Journal of Diabetes

DOI: https://doi.org/10.1111/1753-0407.13561 · OSTI ID:2350990

De la Torre, Katherine ^[1]; Song, Minkyo ^[2]; Abe, Sarah Krull ^[3]; Rahman, Md. Shafiur ^[4]; Islam, Md. Rashedul ^[5]; Saito, Eiko ^[6]; Min, Sukhong ^[1]; Huang, Dan ^[1]; Chen, Yu ^[7]; Gupta, Prakash C. ^[8]; Sawada, Norie ^[3]; Tamakoshi, Akiko ^[9]; Shu, Xiao‐Ou ^[10]; Wen, Wanqing ^[10]; Sakata, Ritsu ^[11]; Kim, Jeongseon ^[12]; Nagata, Chisato ^[13]; Ito, Hidemi ^[14]; Park, Sue K. ^[1]; Shin, Myung‐Hee ^[15] ; Pednekar, Mangesh S. ^[8]; Tsugane, Shoichiro ^[16]; Kimura, Takashi ^[9]; Gao, Yu‐Tang ^[17]; Cai, Hui ^[10]; Wada, Keiko ^[13]; Oze, Isao ^[18]; Shin, Aesun ^[1]; Ahn, Yoon‐Ok ^[1]; Ahsan, Habibul ^[19]; Boffetta, Paolo ^[20]; Chia, Kee Seng ^[21]; Matsuo, Keitaro ^[22]; Qiao, You‐Lin ^[23]; Rothman, Nathaniel ^[24]; Zheng, Wei ^[10]; Inoue, Manami ^[3]; Kang, Daehee  ^[1]

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1. Seoul National Univ. (Korea, Republic of)
2. National Cancer Institute, Bethesda, MD (United States); National Institute on Aging, Baltimore, MD (United States)
3. National Cancer Center Institute for Cancer Control, Tokyo (Japan)
4. National Cancer Center Institute for Cancer Control, Tokyo (Japan); Hamamatsu University School of Medicine, Tokyo (Japan)
5. National Cancer Center Institute for Cancer Control, Tokyo (Japan); Hitotsubashi University, Tokyo (Japan)
6. National Center for Global Health and Medicine, Tokyo (Japan)
7. New York Univ. (NYU), NY (United States). Grossman School of Medicine
8. Healis Sekhsaria Institute for Public Health (India)
9. Hokkaido University (Japan)
10. Vanderbilt Univ., Nashville, TN (United States)
11. Radiation Effects Research Foundation, Hiroshima (Japan)
12. National Cancer Center, Goyang (Korea, Republic of)
13. Gifu University (Japan)
14. Aichi Cancer Center (Japan); Nagoya Univ. (Japan)
15. Sungkyunkwan University (Korea, Republic of)
16. National Cancer Center Institute for Cancer Control, Tokyo (Japan); International University of Health and Welfare (Japan)
17. Shanghai Cancer Institute (China); Shanghai Jiaotong University (China)
18. Aichi Cancer Center (Japan)
19. Univ. of Chicago, IL (United States)
20. Univ. of Bologna (Italy); Stony Brook Univ., NY (United States)
21. National University of Singapore (Singapore)
22. Aichi Cancer Center (Japan); Nagoya University (Japan)
23. Chinese Academy of Medical Sciences (China); Peking Union Medical College, Beijing (China)
24. National Cancer Institute, Bethesda, MD (United States)

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. 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. 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. 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.

• 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, Vol. 16, Issue 6; ISSN 1753-0393
• Publisher: Wiley and Ruijin Hospital, Shanghai Jiaotong University School of MedicineCopyright Statement
• Country of Publication: United States
• Language: English