Xiaochen Shu1,2, Jianguang Ji2, Xinjun Li2, Jan Sundquist2,3, Kristina Sundquist1,2, Kari Hemminki1,2,4
1Center for Family and Community Medicine, Karolinska Institute, Huddinge
2Center for Primary Health Care Research, Lund University, Malmö, Sweden
3Stanford Prevention Research Center, Stanford University School of Medicine, CA, USA
4Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany;
Tóm tắt
Diabet. Med. 27, 791–797 (2010)AbstractAims Type 1 diabetes mellitus (T1DM) is an autoimmune disease with potential mechanistic links to immune‐related cancers. We aimed at examining the overall and specific cancer risks among hospitalized T1DM patients from the national registers in Sweden.Methods A T1DM research cohort was created by identifying T1DM patients from the Hospital Discharge Register and linking them with the Cancer Registry. Standardized incidence ratios (SIRs) for subsequent cancers were calculated among patients with T1DM compared with those without T1DM.Results Two hundred and fifty‐eight cases were ascertained with subsequent cancers during the follow‐up duration from 1964 to 2006, with an increased overall SIR of 1.17 (95% CI 1.04–1.33) among 24 052 T1DM patients identified at baseline. Significant excess was noted for gastric and skin (squamous cell carcinoma) cancers and for leukaemia. Increased risk of acute lymphatic leukaemia accounted for most of the variation of leukaemia risk (SIR = 5.31, 95% CI 3.32–8.05). Cancer risk varied with sex, age at first hospitalization and numbers of hospitalizations. The risk was higher in women compared with men and in those hospitalized for T1DM at age over 10 years compared with the younger patients. Higher risks were also found among those with more hospital visits.Conclusion By quantifying the variations of overall and site‐specific cancer risks after T1DM, the current study provides novel associations between T1DM and subsequent cancers, the mechanisms of which remain to be established.
