Diabetes, Cardiovascular, and Heart Diseases  Article 312     Published on March 12, 2018

An earlier study shows that diabetes and higher body mass index (a risk factor to type 2 diabetes) are the risk factors to multiple types of cancers such breast, colorectal, endometrial, gallbladder, liver and pancreatic cancers. But that study did not show the number of new cancer patients due to diabetes or higher body mass index.

A comparative risk assessment study from 175 countries was done by British researchers. The study shows an increased risk of multiple forms of cancer in people with diabetes and with a body mass index (BMI) more than 25 kg/meter².

Researchers say that the possible reason for the strong association between cancer and diabetes and the high body mass index was due to the biological mechanisms such as chronic inflammation, hyperglycemia (high blood sugar levels. Type 2 diabetes), hyperinsulinemia (excess levels of insulin in the blood) and the dysregulation of sex hormone activity. They also say that factors such as insulin resistance and inflammation due to the increased fat tissue may also increase the risk of cancer.

In a first documented study, researchers have analyzed the development of 12 types of cancers with diabetes or a higher body mass index as the risk factors. The study shows cancer in 792,000 or 5.6 percent of the patients was due to the combined effects of high body mass index (BMI) and diabetes in the year 2012.

For the study purpose, researchers have used the GLOBOCAN data for estimating the number of cancer patients and the percentage of patients in each country and in each region. The study shows.

* The new cancer patients due to the higher body mass index (BMI) was 544,300 and due to the diabetes were 280,000.

* The new cancer patients between 1980 and 2002 due to the increased prevalence of diabetes were 77,000 or 26.1 percent and due to the higher body mass index (BMI) was 174,040 or 31.9 percent.

* Most of the new cancer patients due to the higher body mass index (BMI) and diabetes were in the western countries then followed by the countries in East Asia and Southeast Asia.

* The new cancer patients due to the higher body mass index (BMI) and diabetes are less common among the countries with low income and more common among the high-income countries. But there was a big increase in the new cancer patients in the low and middle-income countries between 1980 and 2002.

* The patients of liver cancer in men are about 42.8 percent of the total cancer patients then followed by colorectal cancer. The patients of breast cancer in women are about 29.7 percent of the cancer patients then followed by endometrial cancer.

* The study has found a strong association between the risk of cancer and higher body mass index (BMI) and diabetes among women. The number of cancer patients in women is 496,700 when compared to 295,900 patients in men.

The new cancer patients are expected to increase further due to lifestyle changes. Cancer patients in the coming years are expected to increase to more than 20 percent in men and to more than 30 percent in women. But these two risk factors are preventable with lifestyle changes.

Researchers say that insulin may be a form of oncogenic viruses as earlier studies show a higher risk to colorectal and breast cancer with hyperinsulinemia. The risk of cancer with insulin is irrespective of the body mass index (BMI). But the study could not show the cause and effect relationship between cancer or any other risk factors.

The lead author of the Wellcome Trust and NIHR funded study was Dr. Jonathan Pearson-Stuttard, Imperial College in London. The study was published November 28, 2017, in The Lancet. Title of the article was "Worldwide burden of cancer attributable to diabetes and high body-mass index: a comparative risk assessment."
DOI: doi.org/10.1016/S2213-8587(17)30366-2

       
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Oncogene: Oncogene is a cancer-causing DNA or RNA gene. DNA and RNA virus may cause tumors (tumours) in animals. In humans, all DNA virus and a single-stranded RNA virus may cause cancer.

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