Association between type 2 diabetes and risk of cancer mortality: a pooled analysis of over 771,000 individuals in the Asia Cohort Consortium

Yu Chen, Fen Wu, Eiko Saito, Yingsong Lin, Minkyo Song, Hung N. Luu, Prakash C. Gupta, Norie Sawada, Akiko Tamakoshi, Xiao Ou Shu, Woon Puay Koh, Yong Bing Xiang, Yasutake Tomata, Kemmyo Sugiyama, Sue K. Park, Keitaro Matsuo, Chisato Nagata, Yumi Sugawara, You Lin Qiao, San Lin YouRenwei Wang, Myung Hee Shin, Wen Harn Pan, Mangesh S. Pednekar, Shoichiro Tsugane, Hui Cai, Jian Min Yuan, Yu Tang Gao, Ichiro Tsuji, Seiki Kanemura, Hidemi Ito, Keiko Wada, Yoon Ok Ahn, Keun Young Yoo, Habibul Ahsan, Kee Seng Chia, Paolo Boffetta, Wei Zheng, Manami Inoue, Daehee Kang, John D. Potter

Research output: Contribution to journalArticlepeer-review


Aims/hypothesis: The aims of the study were to evaluate the association between type 2 diabetes and the risk of death from any cancer and specific cancers in East and South Asians. Methods: Pooled analyses were conducted of 19 prospective population-based cohorts included in the Asia Cohort Consortium, comprising data from 658,611 East Asians and 112,686 South Asians. HRs were used to compare individuals with diabetes at baseline with those without diabetes for the risk of death from any cancer and from site-specific cancers, including cancers of the oesophagus, stomach, colorectum, colon, rectum, liver, bile duct, pancreas, lung, breast, endometrium, cervix, ovary, prostate, bladder, kidney and thyroid, as well as lymphoma and leukaemia. Results: During a mean follow-up of 12.7 years, 37,343 cancer deaths (36,667 in East Asians and 676 in South Asians) were identified. Baseline diabetes status was statistically significantly associated with an increased risk of death from any cancer (HR 1.26; 95% CI 1.21, 1.31). Significant positive associations with diabetes were observed for cancers of the colorectum (HR 1.41; 95% CI 1.26, 1.57), liver (HR 2.05; 95% CI 1.77, 2.38), bile duct (HR 1.41; 95% CI 1.04, 1.92), gallbladder (HR 1.33; 95% CI 1.10, 1.61), pancreas (HR 1.53; 95% CI 1.32, 1.77), breast (HR 1.72; 95% CI 1.34, 2.19), endometrium (HR 2.73; 95% CI 1.53, 4.85), ovary (HR 1.60; 95% CI 1.06, 2.42), prostate (HR 1.41; 95% CI 1.09, 1.82), kidney (HR 1.84; 95% CI 1.28, 2.64) and thyroid (HR 1.99; 95% CI 1.03, 3.86), as well as lymphoma (HR 1.39; 95% CI 1.04, 1.86). Diabetes was not statistically significantly associated with the risk of death from leukaemia and cancers of the bladder, cervix, oesophagus, stomach and lung. Conclusions/interpretation: Diabetes was associated with a 26% increased risk of death from any cancer in Asians. The pattern of associations with specific cancers suggests the need for better control (prevention, detection, management) of the growing epidemic of diabetes (as well as obesity), in order to reduce cancer mortality.

Original languageEnglish (US)
Pages (from-to)1022-1032
Number of pages11
Issue number6
StatePublished - Jun 1 2017


  • Asia Cohort Consortium
  • Asians
  • Cancer mortality
  • Meta-analysis
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism


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