Introduction and Objective: Type 2 diabetes (T2D) may be associated with higher cancer risk through chronic inflammation, insulin resistance, and obesity. We assessed cancer risks across T2D subtypes.Methods: Newly diagnosed T2D (n = 727,076; age: 64.4 years [SD:13.3], 52% female) over 2012-2023 from the Epic Cosmos platform were classified into Severe Insulin-Deficient Diabetes (SIDD, 21.6%), Mild Obesity-Related Diabetes (MOD, 23.8%), or Mild Age-Related Diabetes (MARD, 40.9%) using reliable algorithms. Unclassified cases were labeled as Mixed (13.7%). First occurrence of cancers (colorectal, liver, pancreatic, female [breast, endometrial, and ovarian], prostate) within ten years after T2D diagnosis were identified using ICD-10-CM codes. Cox proportional hazards models were used to estimate absolute and relative hazards (HR) by subtype, adjusted for age, sex, and smoking.Results: Cumulative cancers were highest in MOD and Mixed. Patterns for specific cancer risks differed: compared to MOD (Figure), SIDD and MARD had 35-111% higher hazards of liver, pancreatic, and prostate cancers but 10-36% lower hazards of colorectal and female cancers.Conclusion: Novel subtypes exhibit varying risks for different cancers, highlighting opportunities for early screening and tailored prevention strategies.
Z. Li: None. B. Salazar: None. J. Guo: None. K.O. Sanaka: None. P. Vellanki: Advisory Panel; Eli Lilly and Company. M.K. Ali: Advisory Panel; Eli Lilly and Company. C. Hofmeister: Research Support; AbbVie Inc, Sanofi, Bristol-Myers Squibb Company. J. Varghese: None.
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