Cancer risk following onset of type 2 diabetes in New Zealanders with impaired glucose tolerance over 25 years: a matched prospective cohort study

Wang, Zheng; Yu, Dahai; Osuagwu, Uchechukwu Levi; Pickering, Karen; Baker, John; Cutfield, Richard; Cai, Yamei; Orr-Walker, Brandon J.; Sundborn, Gerhard; Qu, Bingjie; Zhao, Zhanzheng; Simmons, David

Abstract

In people with prediabetes, the link between developing type 2 diabetes (T2D) and cancer risk among those with impaired glucose tolerance (IGT) remains uncertain. We examined this association in IGT individuals from primary care in South and West Auckland, New Zealand, spanning 1994–2019, assessing 5- and 10-year cancer risks.

Methods
Study cohorts were extracted from the Diabetes Care Support Service in Auckland, New Zealand, linking it with national registries for death, cancer, hospital admissions, pharmaceutical claims, and socioeconomic status. We compared cancer risks in individuals with IGT newly diagnosed with or without T2D within a 1–5-year exposure window. Employing tapered matching and landmark analysis to address potential confounding effects, we formed comparative IGT cohorts. Weighted Cox regression models were then employed to assess the association between T2D onset and 5- and 10-year cancer risks.

Results
The study included 26,794 patients with IGT, with 629 newly diagnosed with T2D within 5 years and 13,007 without such a diagnosis. Those progressing to T2D had similar 5-year cancer risk but significantly higher 10-year risk (HR 1.35; 95% CI 1.09–1.68). This association was stronger in older individuals, the socioeconomically deprived, current smokers, those with worse metabolic measures, and lower renal function. Patients with IGT of NZ European ethnicity had lower 10-year cancer risk.

Conclusions
T2D diagnosis influences cancer risk in individuals with IGT. Developing risk scores for high-risk IGT individuals and implementing cancer screening and structured diabetes prevention, especially in deprived or minority ethnic populations, is essential.

Citation

Wang, Z., Yu, D., Osuagwu, U. L., Pickering, K., Baker, J., Cutfield, R., Cai, Y., Orr-Walker, B. J., Sundborn, G., Qu, B., Zhao, Z., & Simmons, D. (in press). Cancer risk following onset of type 2 diabetes in New Zealanders with impaired glucose tolerance over 25 years: a matched prospective cohort study. BMC Cancer, 24(1), Article 892. https://doi.org/10.1186/s12885-024-12637-4

• Journal Article Type: Article
• Acceptance Date: Jul 12, 2024
• Online Publication Date: Jul 24, 2024
• Deposit Date: Aug 9, 2024
• Publicly Available Date: Aug 9, 2024
• Journal: BMC Cancer
• Electronic ISSN: 1471-2407
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 24
• Issue: 1
• Article Number: 892
• DOI: https://doi.org/10.1186/s12885-024-12637-4
• Keywords: Impaired glucose tolerance, Tapered matching, New Zealand, Landmark analysis, Cancer, Type 2 diabetes
• Public URL: https://keele-repository.worktribe.com/output/880277