Older Patients With Diabetes May Have 1.5-Fold Increased Risk for Death From Cancer


Patients with type 2 diabetes have an increased cancer burden and, as a result, a higher mortality rate, highlighting the importance of inflammatory factors like obesity and glucose control.

The increased risk for cancer in patients with diabetes may also contribute to their increased mortality risk, according to findings from a recent study.

In a study published in the journal Diabetologia, researchers found that older patients with type 2 diabetes had a 1.5-fold increased risk for mortality from colorectal, pancreatic, endometrial and liver cancers.

“The most important point highlighted in this study are that mortality rates for patients with type 2 diabetes have reduced in some countries because of focus on reduction in cardiovascular disease prevention,” Dr. Sonali Thosani, associate professor and section chief of diabetes at The University of Texas MD Anderson Cancer Center in Houston, told CURE®. “While fewer patients with type 2 diabetes are dying from cardiovascular disease, we are now seeing more deaths due to cancer.”

The study included 137,804 patients aged 35 years and older who were newly diagnosed with type 2 diabetes. During a median of 8.4 years of follow-up, researchers focused on mortality rates including those by any cause and by cancer-related causes.

During follow-up, rates of mortality from cancer decreased for patients younger than 75 years and increased for those aged 75 years and older. In contrast, cancer mortality rates were decreasing for patients in the younger age groups.

“As average life expectancy has continued to rise globally, we are seeing all patients (including those with diabetes) living longer,” said Thosani, who was not one of the researchers who worked on this study. “This study highlights that while there is a decline in all-cause mortality for the general population, for older patients with type 2 diabetes, there is a higher cancer burden resulting in an increased mortality in this patient population.”

Although this study was performed in patients from the U.K., Thosani said that these findings may also be applicable to patients in the U.S.

“This study could likely apply to similar patients in the U.S., though some of the major limitations are that patients were classified as White and non-White (patients), which limits our ability to ascertain the differences that specific ethnic backgrounds may have contributed to overall mortality risk and access to care.”

In fact, Thosani mentioned that the difference in health care systems between the U.K. and the U.S. may provide more information on patients with cancer and diabetes.

“The health care system in the U.S. is different than the U.K., as we do not have universal health care,” she said. “I would suspect that we may see even greater disparities in our patient population with type 2 diabetes and cancer risk if we account for the similar variables that were considered in this study.”

Thosani advised patients in the importance of controlling the factors commonly seen in both diabetes and cancer.

“Both cancer and diabetes are pro-inflammatory states, and improving diabetes control has been shown to improve cancer outcomes in certain cancer subtypes,” she said. “Obesity is very common in patients with type 2 diabetes and is a common factor in increasing risk of cancer development. In addition to improving glucose control, patients with diabetes need to ensure that their clinical team is helping with treatment to reduce weight and providing age-appropriate cancer screening based on risk factors.”

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