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Those with type 2 diabetes twice as likely to die from some cancers

The study looked at 137,804 individuals aged 35 and over with newly diagnosed type 2 diabetes with an average follow-up of 8.4 years.

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medicine, diabetes, glycemia, health care and people concept - close up of woman with syringe making insulin injection to himself at home
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By Jim Leffman via SWNS

Those with type 2 diabetes are twice as likely to die from some cancers as the general population, a new study reveals.

Those with colorectal, liver, pancreatic and endometrial cancer were most at risk, whilst deaths of women with breast cancer and type 2 diabetes were rising - against the national trend.

However overall, the death rate of people with cancer and type 2 diabetes fell slightly in the 55-65 age group but rose for those aged 75-85.

But smokers were still more at risk if they also had type 2 diabetes.

The research, published in the journal Diabetologia found that having type 2 diabetes gave an overall increase of likelihood of death from cancer of 18 per cent compared to the general population.

In breast cancer, where deaths are falling, there was a nine percent increase but in cases of colorectal cancer the risk increased two and a half times.

And in cases of liver, pancreatic and endometrial cancers the risk was doubled.

The 20 year study from 1998 to 2018 was jointly run by the University of Leicester and London School of Hygiene & Tropical Medicine.

Lead author Dr. Suping Ling said: “In conclusion, our findings underline the growing cancer burden in people with type 2 diabetes, particularly in older individuals, and highlight the need to prioritize cancer prevention, research and early detection and management in this population, especially for colorectal, pancreatic, liver and endometrial cancer, whose mortality rates were substantially higher in individuals with type 2 diabetes than in the general population.”

The study looked at 137,804 individuals aged 35 and over with newly diagnosed type 2 diabetes with an average follow-up of 8.4 years.

They analyzed trends in all-cause, all-cancer and cancer-specific mortality rates by age, gender, ethnicity, socioeconomic status, obesity and smoking status.

They also estimated standardized mortality ratios comparing mortality rates in people with type 2 diabetes with the general population.

It is thought the increased risk was down to prolonged exposure to the effects of increased blood sugar and insulin levels, insulin resistance and chronic inflammation.

Top view of flat lay of medical supplies for the treatment of the patient - with de word diabetes in a white background
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However decreasing cardiovascular death in older age groups due to better treatment and prevention means that people live longer and have a greater chance of dying from other causes including cancer.

And diabetes screening, better management of diabetes and its complications, and earlier cancer detection and treatments seem to have benefited younger people with type 2 diabetes in the same way as they have in the general population.

Despite national reports showing a decrease in breast cancer morality in the younger age ranges in this study, this new research showed also showed an increasing breast cancer mortality rates by 4.1% per year in the younger women with type 2 diabetes.

Ling said: “From this perspective, our results suggest that it may be helpful to extend breast cancer screening to young women with type 2 diabetes.

"However, given the high cost and potentially longer exposure to screening procedures, cost-effectiveness analyses are required to define the appropriate time window and identify subgroups who may benefit more.”

He added: “The prevention of cardiovascular disease has been, and is still considered, a priority in people with diabetes.

"Our results challenge this view by showing that cancer may have overtaken cardiovascular disease as a leading cause of death in people with type 2 diabetes.

"Cancer prevention strategies therefore deserve at least a similar level of attention as cardiovascular disease prevention, particularly in older people and for some cancers such as liver, colorectal and pancreatic cancer.

"Tailored interventions should also be considered for smokers, who had higher and steadily increasing cancer mortality rates.

"For people with type 2 diabetes, early cancer detection through changes to existing screening programs, or more in-depth investigations for suspected or non-specific cancer symptoms, may reduce the number of avoidable cancer deaths.”

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