The risk of cancer in people with diabetes and chronic kidney disease

Germaine Wong, Sophia Zoungas, Serigne Lo, John Chalmers, Alan Cass, Bruce Neal, Mark Woodward, Vlado Perkovic, Paul Glasziou, Bryan Williams, Kirsten Howard, Jeremy R. Chapman, Jonathan C. Craig

Research output: Contribution to journalArticle

Abstract

Background. Diabetes and chronic kidney disease (CKD) are both associated with an increased risk of cancer but it is unclear whether diabetes complicated by CKD further augments an individual's cancer risk. The aim of our study was to determine the association of CKD [defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min] with the overall and site-specific risks of incident cancers among individuals with Type 2 diabetes. Methods. Cox proportional hazard regression models and competing risk analyses were used to examine the univariate and multivariate adjusted associations between reduced kidney function and the overall and site-specific risks of cancer in participants enrolled in the Action in Diabetes and Vascular disease: Preterax and Diamicron MR controlled evaluation (ADVANCE) trial. Results. Over a median follow-up of 5.0 years, 700 malignant neoplasms occurred in the 11 140 (6.4) participants. There was no increase in overall cancer risk [adjusted hazard ratio: 1.07 (95 confidence interval: 0.891.29, P 0.50)] or site-specific cancer risk for individuals with CKD (defined as eGFR < 60 mL/min) compared to those without CKD at baseline. These results were robust to multiple methods and thresholds used to estimate CKD. Conclusion. sMild to moderate CKD does not increase the risk of cancer in people with Type 2 diabetes. ADVANCE is registered with ClincalTrial.gov (number NCT00145925).

Original languageEnglish (US)
Pages (from-to)3337-3344
Number of pages8
JournalNephrology Dialysis Transplantation
Volume27
Issue number8
DOIs
StatePublished - Aug 1 2012

Keywords

  • CKD
  • cancer
  • cumulative incidence
  • diabetes

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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  • Cite this

    Wong, G., Zoungas, S., Lo, S., Chalmers, J., Cass, A., Neal, B., Woodward, M., Perkovic, V., Glasziou, P., Williams, B., Howard, K., Chapman, J. R., & Craig, J. C. (2012). The risk of cancer in people with diabetes and chronic kidney disease. Nephrology Dialysis Transplantation, 27(8), 3337-3344. https://doi.org/10.1093/ndt/gfs022