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Study Strengthens Evidence of Link Between Liver Cancer and Diabetes

Study Strengthens Evidence of Link Between Liver Cancer and Diabetes

SEATTLE-Diabetics may face three times the risk of liver cancer, according to data from a new study. A number of epidemiological studies have "suggested a relationship between some cancer types and diabetes, and the most consistent results have been for cancers of the liver and the pancreas," said Marie-Claude Rousseau, PhD, a postdoctoral fellow, in the Department of Social and Preventive Medicine, at the University of Montreal Faculty of Medicine. "Some biological mechanisms have been proposed to suggest how diabetes affects the risk of cancer, but to this day, they remain only hypothetical. So clearly, the question of whether cancer risk is associated with diabetes is still open," Dr. Rousseau said. She presented the findings at the American Association for Cancer Research Third Annual International Conference on Frontiers in Cancer Prevention Research (abstract 195). The investigators used data collected from a study conducted in Mon treal during the 1980s designed to address workplace factors and the risk of cancer among men. The large population- based multisite case-control study included information about prior diagnosis for diabetes, age at diagnosis, and medication use for diabetes. The study sample was comprised of 3,288 male patients who had been recently diagnosed with cancer and 509 healthy controls. Patients with diabetes also provided information about their usual height and weight and lifestyle factors. "These are important to consider when studying diabetes and cancer risk," Dr. Rousseau said. The investigative team analyzed the association between diabetes and 12 different types of cancer. "Out of the 20 different cancer types that were documented in this study, our analyses focused on 12 types for which the number of patients was large enough to provide sufficient statistical power for the analyses," she explained. Study Results After adjusting for body mass index and other covariates, the risk of liver cancer was found to be elevated among men who reported a prior diagnosis of diabetes. The adjusted odds ratio (OR) was 3.1. The proportion of diabetics was 24% among liver cancer patients, while only 8% of controls reported having diabetes. "These estimates were slightly higher when we used a more stringent definition of diabetes," Dr. Rousseau said. This definition included only those subjects who were taking medication. The adjusted odds ratio for liver cancer for this subgroup was 3.9. An association was observed with pancreatic cancer, mostly due to recently diagnosed diabetes. "This may suggest that diabetes was a result of the pancreatic cancer rather than the opposite," Dr. Rousseau said. The researchers did not observe any association with other cancers studied, including melanoma, non- Hodgkin's lymphoma, and cancers of the esophagus, stomach, colon, rectum, lung, prostate, bladder, and kidney. "While this was not the first study to examine the link between cancer and diabetes, key features of our studies were that we could assess the risk of several different cancer types in the same population and that the patients were newly diagnosed," Dr. Rousseau said. "Also, we had information that allowed us to adjust for important factors, such as body mass index, smoking, and alcohol consumption. In conclusion, our study is strengthening the evidence of a link between diabetes and liver cancer." Dr. Rousseau's colleagues in the study were Jack Siemiatycki, PhD, University of Montreal, and Marie-Elise Parent, PhD, INRS-Institut Armand- Frappier, Laval, Quebec.

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