Diabetes Metab J.  2019 Dec;43(6):733-743. 10.4093/dmj.2019.0177.

Diabetes and Cancer: Cancer Should Be Screened in Routine Diabetes Assessment

• Suh S
• Kim KW

• KMID: 2466494
• DOI: http://doi.org/10.4093/dmj.2019.0177

Abstract

Cancer incidence appears to be increased in both type 1 and type 2 diabetes mellitus (DM). DM represents a risk factor for cancer, particularly hepatocellular, hepatobiliary, pancreas, breast, ovarian, endometrial, and gastrointestinal cancers. In addition, there is evidence showing that DM is associated with increased cancer mortality. Common risk factors such as age, obesity, physical inactivity and smoking may contribute to increased cancer risk in patients with DM. Although the mechanistic process that may link diabetes to cancer is not completely understood yet, biological mechanisms linking DM and cancer are hyperglycemia, hyperinsulinemia, increased bioactivity of insulin-like growth factor 1, oxidative stress, dysregulations of sex hormones, and chronic inflammation. However, cancer screening rate is significantly lower in people with DM than that in people without diabetes. Evidence from previous studies suggests that some medications used to treat DM are associated with either increased or reduced risk of cancer. However, there is no strong evidence supporting the association between the use of anti-hyperglycemic medication and specific cancer. In conclusion, all patients with DM should be undergo recommended age- and sex appropriate cancer screenings to promote primary prevention and early detection. Furthermore, cancer should be screened in routine diabetes assessment.

Keyword

Diabetes mellitus; Mass screening; Neoplasms

MeSH Terms

Breast
Diabetes Mellitus
Diabetes Mellitus, Type 2
Early Detection of Cancer
Gastrointestinal Neoplasms
Gonadal Steroid Hormones
Humans
Hyperglycemia
Hyperinsulinism
Incidence
Inflammation
Mass Screening
Mortality
Obesity
Oxidative Stress
Pancreas
Primary Prevention
Risk Factors
Smoke
Smoking
Gonadal Steroid Hormones
Smoke

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