Incident Early-and Later-Onset Type 2 Diabetes and Risk of Early-and Later-Onset Cancer: Prospective Cohort Study

Yin Zhang, Mingyang Song, Yin Cao, A. Heather Eliassen, Brian M. Wolpin, Meir J. Stampfer, Walter C. Willett, Kana Wu, Kimmie Ng, Frank B. Hu, Edward L. Giovannucci

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7 Scopus citations

Abstract

OBJECTIVE We evaluated prospectively the association between incident early-onset (diag-nosed before 40 years of age) and later-onset type 2 diabetes and early-onset (di-agnosed before 50 years of age) and later-onset cancer risk. RESEARCH DESIGN AND METHODS We prospectively followed 228,073 eligible participants in the Nurses’ Health Studies for up to 38 years. Hazard ratios (HRs) and 95% CI were estimated using Cox models. RESULTS We documented 18,290 type 2 diabetes, 6,520 early-onset cancer, and 36,907 later-onset cancer cases during follow-up. In fully adjusted analyses, early-onset type 2 diabetes was associated with increased risk of early-onset total cancer (HR [95% CI] 1.47 [1.06–2.04]), diabetes-related cancer (2.11 [1.38–3.23]), and obe-sity-related cancer (1.75 [1.08–2.82]), and the risk elevations were restricted to those with a BMI at 18 years of age of ‡21 kg/m2 (total cancer: 1.75 [1.20–2.56]; diabetes-related cancer: 2.43 [1.50–3.94]; and obesity-related cancer: 1.84 [1.05–3.22]). Early-onset type 2 diabetes was associated with higher risk of later-onset diabetes-related and obesity-related cancer specifically among individuals with higher BMI at 18 years of age. Later-onset type 2 diabetes was associated with a higher risk of later-onset total cancer (1.15 [1.11–1.20]), diabetes-related cancer (1.17 [1.12–1.22]), and obesity-related cancer (1.18 [1.13–1.24]). In analyses based on refined timing, the HRs attenuated substantially with aging. CONCLUSIONS Incident early-onset type 2 diabetes was associated with increased risk of early-onset total cancer and diabetes-and obesity-related cancer, especially in those with higher BMI at 18 years of age. The impact of early-onset type 2 diabetes on cancer risk may be inherently stronger than that of later-onset type 2 diabetes.

Original languageEnglish
Pages (from-to)120-129
Number of pages10
JournalDiabetes care
Volume46
Issue number1
DOIs
StatePublished - Jan 2023

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