Diabetes mellitus is associated with an increased risk of gastric cancer: a cohort study

Hyo Joon Yang, Danbee Kang, Yoosoo Chang, Jiin Ahn, Seungho Ryu, Juhee Cho, Eliseo Guallar, Chong Il Sohn

Research output: Contribution to journalArticle

Abstract

Background: Diabetes mellitus (DM) has been considered a potential risk factor for gastric cancer, but the evidence is conflicting. We evaluated the association of DM with incident gastric cancer in a large cohort of men and women with endoscopic assessment at baseline and during follow-up. Methods: We performed a retrospective cohort study of 195,312 adult men and women who underwent upper endoscopy at baseline and during follow-up between 2003 and 2014. DM was defined as fasting serum glucose ≥ 126 mg/dL, self-reported history of DM or current use of antidiabetic medications. Gastric cancer was confirmed histologically. Results: The prevalence of DM at baseline was 3.0% (n = 5774). Over 865,511 person-years of follow-up, 198 participants developed gastric cancer. The fully adjusted hazard ratio (HR) for incident gastric cancer comparing participants with and without DM at baseline was 1.76 [95% confidence interval (CI) 1.04–2.97; P = 0.033). When we evaluated DM as a time-varying covariate, the fully adjusted HR was 1.66 (95% CI 1.04–2.68; P = 0.036). The association between DM and incident gastric cancer did not differ by the presence of intestinal metaplasia (P for interaction = 0.61). Conclusions: In this large cohort with endoscopic follow-up, DM was independently associated with increased gastric cancer incidence. The increased risk was independent of mucosal atrophy and intestinal metaplasia and was consistent in participants with newly developed DM during follow-up. Patients with DM may require more intensive endoscopic follow-up for gastric cancer screening.

Original languageEnglish (US)
JournalGastric Cancer
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Stomach Neoplasms
Diabetes Mellitus
Cohort Studies
Metaplasia
Confidence Intervals
Early Detection of Cancer
Hypoglycemic Agents
Endoscopy
Atrophy
Fasting
Retrospective Studies
Glucose
Incidence
Serum

Keywords

  • Cohort studies
  • Diabetes mellitus
  • Gastric cancer
  • Gastroscopy
  • Stomach neoplasms

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

Cite this

Yang, H. J., Kang, D., Chang, Y., Ahn, J., Ryu, S., Cho, J., ... Sohn, C. I. (Accepted/In press). Diabetes mellitus is associated with an increased risk of gastric cancer: a cohort study. Gastric Cancer. https://doi.org/10.1007/s10120-019-01033-8

Diabetes mellitus is associated with an increased risk of gastric cancer : a cohort study. / Yang, Hyo Joon; Kang, Danbee; Chang, Yoosoo; Ahn, Jiin; Ryu, Seungho; Cho, Juhee; Guallar, Eliseo; Sohn, Chong Il.

In: Gastric Cancer, 01.01.2019.

Research output: Contribution to journalArticle

Yang, Hyo Joon ; Kang, Danbee ; Chang, Yoosoo ; Ahn, Jiin ; Ryu, Seungho ; Cho, Juhee ; Guallar, Eliseo ; Sohn, Chong Il. / Diabetes mellitus is associated with an increased risk of gastric cancer : a cohort study. In: Gastric Cancer. 2019.
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AU - Yang, Hyo Joon

AU - Kang, Danbee

AU - Chang, Yoosoo

AU - Ahn, Jiin

AU - Ryu, Seungho

AU - Cho, Juhee

AU - Guallar, Eliseo

AU - Sohn, Chong Il

PY - 2019/1/1

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N2 - Background: Diabetes mellitus (DM) has been considered a potential risk factor for gastric cancer, but the evidence is conflicting. We evaluated the association of DM with incident gastric cancer in a large cohort of men and women with endoscopic assessment at baseline and during follow-up. Methods: We performed a retrospective cohort study of 195,312 adult men and women who underwent upper endoscopy at baseline and during follow-up between 2003 and 2014. DM was defined as fasting serum glucose ≥ 126 mg/dL, self-reported history of DM or current use of antidiabetic medications. Gastric cancer was confirmed histologically. Results: The prevalence of DM at baseline was 3.0% (n = 5774). Over 865,511 person-years of follow-up, 198 participants developed gastric cancer. The fully adjusted hazard ratio (HR) for incident gastric cancer comparing participants with and without DM at baseline was 1.76 [95% confidence interval (CI) 1.04–2.97; P = 0.033). When we evaluated DM as a time-varying covariate, the fully adjusted HR was 1.66 (95% CI 1.04–2.68; P = 0.036). The association between DM and incident gastric cancer did not differ by the presence of intestinal metaplasia (P for interaction = 0.61). Conclusions: In this large cohort with endoscopic follow-up, DM was independently associated with increased gastric cancer incidence. The increased risk was independent of mucosal atrophy and intestinal metaplasia and was consistent in participants with newly developed DM during follow-up. Patients with DM may require more intensive endoscopic follow-up for gastric cancer screening.

AB - Background: Diabetes mellitus (DM) has been considered a potential risk factor for gastric cancer, but the evidence is conflicting. We evaluated the association of DM with incident gastric cancer in a large cohort of men and women with endoscopic assessment at baseline and during follow-up. Methods: We performed a retrospective cohort study of 195,312 adult men and women who underwent upper endoscopy at baseline and during follow-up between 2003 and 2014. DM was defined as fasting serum glucose ≥ 126 mg/dL, self-reported history of DM or current use of antidiabetic medications. Gastric cancer was confirmed histologically. Results: The prevalence of DM at baseline was 3.0% (n = 5774). Over 865,511 person-years of follow-up, 198 participants developed gastric cancer. The fully adjusted hazard ratio (HR) for incident gastric cancer comparing participants with and without DM at baseline was 1.76 [95% confidence interval (CI) 1.04–2.97; P = 0.033). When we evaluated DM as a time-varying covariate, the fully adjusted HR was 1.66 (95% CI 1.04–2.68; P = 0.036). The association between DM and incident gastric cancer did not differ by the presence of intestinal metaplasia (P for interaction = 0.61). Conclusions: In this large cohort with endoscopic follow-up, DM was independently associated with increased gastric cancer incidence. The increased risk was independent of mucosal atrophy and intestinal metaplasia and was consistent in participants with newly developed DM during follow-up. Patients with DM may require more intensive endoscopic follow-up for gastric cancer screening.

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