Cited by 627Metabolism, Diabetes, and CancerCancer Risks and FactorsGlobal Cancer Incidence and Screening

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Cancer Incidence in a Population-Based Cohort of Patients Hospitalized With Diabetes Mellitus in Denmark

Wideroff, L., Gridley, G., Chow, W.- H., Linet, M., Mellemkjaer, L., Olsen, J. H., Keehn, S., Borch-Johnsen, K.·1997·JNCI Journal of the National Cancer Institute

DOI 10.1093/jnci/89.18.1360

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Abstract

BACKGROUND: Diabetes has been associated with an increased risk of several cancers, notably cancers of the pancreas, liver, endometrium, and kidney. Since most previous studies have involved a limited sample size or focused on specific cancer sites, we conducted a comprehensive assessment of the risk of cancer in a nationwide cohort of diabetics in Denmark. METHODS: Discharge records of 109581 individuals hospitalized with a diagnosis of diabetes from 1977 through 1989 were linked with national cancer registry records through 1993. Standardized incidence ratios (SIRs) were calculated for specific cancer sites. RESULTS: The SIRs for primary liver cancer were 4.0 (95% confidence interval [CI] = 3.5-4.6) in males and 2.1 (95% CI = 1.6-2.7) in females. These SIRs remained elevated with increasing years of follow-up and after exclusion of patients with reported risk factors (e.g., cirrhosis and hepatitis) or patients whose cancers were diagnosed at autopsy. Kidney cancer risk was also elevated, with SIRs of 1.4 (95% CI = 1.2-1.6) in males and 1.7 (95% CI = 1.4-1.9) in females. For both sexes combined, the SIR for pancreatic cancer was 2.1 (95% CI = 1.9-2.4), with a follow-up time of 1-4 years; this SIR declined to 1.3 (95% CI = 1.1-1.6) after 5-9 years of follow-up. Excess risks were also observed for biliary tract and endometrial cancers. The SIRs for kidney and endometrial cancers declined somewhat after exclusion of diabetics with reported obesity. CONCLUSIONS: Patients hospitalized with a diagnosis of diabetes appear to be at higher risk of developing cancers of the liver, biliary tract, pancreas, endometrium, and kidney. The elevated risks of endometrial and kidney cancers, however, may be confounded by obesity.

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Authors: Wideroff, L., Gridley, G., Chow, W. H., Linet, M., Mellemkjaer, L., Olsen, J. H., Keehn, S., & Borch-Johnsen, K.
Affiliations: National Institutes of Health (US)
National Cancer Institute (US)
Danish Cancer Society (DK)
Information Management Services (US)
University of Copenhagen (DK)
Corresponding author: Wideroff, L.
ORCID: Olsen, J. H.
Venue: JNCI Journal of the National Cancer Institute
Publisher: Oxford University Press (OUP)
Published: 1997-09-17
Volume: 89
Issue: 18
Pages: 1360-1365
ISSN: 0027-8874 (ISSN-L)
1460-2105
DOI: 10.1093/jnci/89.18.1360
OpenAlex: W2122576167
Cited by: 627
References: 42
Citations by year: 2026: 1 · 2025: 5 · 2024: 9 · 2023: 13 · 2022: 14 · 2021: 16 · 2020: 8 · 2019: 19 · 2018: 12 · 2017: 20 · 2016: 20 · 2015: 28 · 2014: 38 · 2013: 43 · 2012: 42
FWCI: 2.26
Type: journal article
Language: en
Open access: closed
Locations: JNCI Journal of the National Cancer Institute (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
Health Sciences › Medicine › Oncology › Cancer Risks and Factors
Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
Keywords: diabetes mellitus, cancer incidence, liver cancer, pancreatic cancer, kidney cancer, endometrial cancer, biliary tract cancer, obesity, standardized incidence ratio, diabetes and cancer association
MeSH terms: Denmark, Female, Hospitalization, Humans, Male, Medical Record Linkage, Middle Aged, Neoplasms, Registries, Risk, Cohort Studies, Incidence, Age Distribution, Sex Distribution, Diabetes Complications

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Cancer Incidence in a Population-Based Cohort of Patients Hospitalized With Diabetes Mellitus in Denmark

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