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Site-specific cancer risk in patients with type 2 diabetes: a nationwide population-based cohort study in Korea

Korean Journal of Internal Medicine 2020년 35권 3호 p.641 ~ 651
김숙경 ( Kim Suk-Kyeong ) - Konkuk University School of Medicine Department of Internal Medicine

장주영 ( Jang Ju-Young ) - Konkuk University Medical Center Department of Internal Medicine
김동림 ( Kim Dong-Lim ) - Konkuk University School of Medicine Department of Internal Medicine
 ( Rhyu Young-A ) - Konkuk University Medical Center Department of Internal Medicine
 ( Lee Suh-Eun ) - Konkuk University Graduate School of Medicine
고승현 ( Ko Seung-Hyun ) - Catholic University College of Medicine Department of Internal Medicine
한경도 ( Han Kyung-Do ) - Catholic University College of Medicine Department of Biostatistics
송기호 ( Song Kee-Ho ) - Konkuk University School of Medicine Department of Internal Medicine

Abstract


Background/Aims: We aimed to evaluate site-specific cancer risk in diabetic patients and to investigate causal and temporal relationships by analyzing organ-specific cancer risk according to the duration of diabetes.

Methods: Using a database provided by the Korean National Health Insurance Service, we conducted a retrospective, population-based cohort study of adults aged ≥ 30 years from January 2005 to December 2013. To verify the possibility of detection bias or reverse causation, we compared hazard ratios (HRs) for each cancer according to the following duration of diabetes: less than 6 months, 6 months to 3 years, and more than 3 years.

Results: The incidence of overall cancer per 1,000 person-years was higher in patients with diabetes than in those without diabetes (20.36 vs. 10.83). The overall cancer risk according to the duration of diabetes was the highest within the first 6 months after diagnosis (HR, 2.03; 95% confidence interval [CI], 1.99 to 2.07), and the HR decreased with the duration of diabetes, ranging from 1.19 (95% CI, 1.18 to 1.21) between 6 months and 3 years to 1.12 (95% CI, 1.11 to 1.13) after 3 years. Both overall cancer risk and HR remained significantly higher in patients with diabetes than in those without diabetes. The risk for prostate cancer was higher in men with diabetes than in those without diabetes (HR, 1.12; 95% CI, 1.10 to 1.14). In women, the risk for endometrial cancer was significantly higher in patients with diabetes than in those without diabetes throughout the duration of diabetes.

Conclusions: The risk for stomach, colorectum, liver, pancreas, and kidney cancer appeared to be higher in patients with diabetes than in those without diabetes regardless of the sex or duration of diabetes.

키워드

Diabetes; Neoplasms; Korean National Health Insurance Service system
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