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Women with diabetes more likely to get cancer, international study shows


Neelima Choahan


27/07/2018 4:06:41 PM

A global review involving almost 20 million people has shown that having diabetes significantly raises the risk of developing cancer, and for women the risk is even higher.

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Women with diabetes are 6% more likely overall to develop any form of cancer than men with diabetes.

Women with diabetes are at a higher risk of developing cancer than men, according to new research.
 
Researchers analysed 47 cohort studies, published up to December 2016, of about 20 million people from countries including the USA, Japan, Australia, China and the UK.
 
Published in Diabetologia, the journal of the European Association for the Study of Diabetes, the research shows that women with diabetes are 6% more likely to develop any form of cancer than men with diabetes.
 
Lead author Dr Toshiaki Ohkuma, research fellow with The George Institute for Global Health, University of NSW, said evidence has already been published showing that women with diabetes are at an increased risk of stroke, coronary heart disease and dementia compared with men with diabetes.
 
However, he said, there has been no systematic overview of the evidence on gender difference in the association between diabetes and cancer.
 
Until now.
 
‘The link between diabetes and the risk of developing cancer is now firmly established,’ Dr Ohkuma said.
 
‘We have also demonstrated for the first time that women with diabetes are more likely to develop any form of cancer, and have a significantly higher chance of developing kidney, oral and stomach cancers and leukaemia.’

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Dr Toshiaki Ohkuma said there has been no systematic overview of the evidence on sex difference in the association between diabetes and cancer.

 
Diabetes affects more than 415 million people worldwide, with five million deaths every year. It is the fastest growing chronic condition in Australia, with 280 people developing the disease every day.
 
‘The number of people with diabetes has doubled globally in the last 30 years, but we still have much to learn about the condition,’ Dr Ohkuma said.
 
‘It’s vital that we undertake more research into discovering what is driving this, and for both people with diabetes and the medical community to be aware of the heightened cancer risk for women and men with diabetes.’
 
Key findings of the new research:
  • Women with diabetes were 27% more likely to develop cancer than women without diabetes. The risk was 19% higher for men.
  • Researchers found that diabetes was a risk factor for the majority of cancers of specific parts of the body for men and women.
  • There were significantly higher risks for women with diabetes for developing cancer of the kidney (11% higher), oral cancer (13% higher), stomach cancer (14% higher) and leukaemia (15% higher) compared to men with the condition.
  • For liver cancer, the risk was 12% lower for women with diabetes compared to men with diabetes.
 
According to Dr Ohkuma, it is believed that heightened blood glucose may have cancer-causing effects by leading to DNA damage.
 
‘Having high blood glucose levels can cause DNA damage, which may have cancer-causing effects,’ he said.
 
‘Women often spend longer duration than men in the pre-diabetic stage where glucose levels are high. In addition, after diagnosis of diabetes, women are often undertreated or not getting the same level of treatment as men.
 
‘This means that cumulative exposure to cancer-causing hyperglycemia may be longer and enhanced in women than men, and thus women are at greater risk of developing cancer than men.’
 
Co-author Dr Sanne Peters, of The George Institute for Global Health at the University of Oxford, said there were several possible reasons why women were subject to an excess risk of cancer, including that they are in the pre-diabetic state of impaired glucose tolerance two years longer on average than men.
 
‘Historically, we know that women are often undertreated when they first present with symptoms of diabetes, are less likely to receive intensive care and are not taking the same levels of medications as men,’ she said. ‘All of these could go some way into explaining why women are at greater risk of developing cancer. But, without more research we can’t be certain.
 
‘The differences we found are not insignificant and need addressing. The more we look into gender-specific research the more we are discovering that women are not only undertreated, they also have very different risk factors for a whole host of diseases, including stroke, heart disease and now diabetes.’
 
Dr Gary Deed, Chair of the RACGP’s Diabetes Specific Interests network, told newsGP the findings are another reminder to improve awareness and implement good clinical care.
 
‘General practices need to be aware about this alleviated risk of cancer in these patients,’ he said.
 
‘Treat all patients, irrespective of gender, the same way for risk-minimisation. But be particularly aware of women in respect to cancer prevention and the need for careful symptom assessment and also screening according to the guidelines.
 
‘In your patients with diabetes, when you are doing annual cycles of care remember to at least contemplate assessment and evaluation of either the symptoms or any signs of cancer appropriate to that individual.’



cancer diabetes kidney cancer leukaemia oral cancer stomach cancer





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