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

Earlier studies show diabetes and higher body mass index (a risk factor to type 2 diabetes) are risk factors to multiple types of cancers such breast, colorectal, endometrial, gallbladder, liver and pancreatic cancers. But those studies did not show the number of new cancer cases due to diabetes or higher body mass index.

A comparative risk assessment study spanning 175 countries done during 2012 by the British researchers shows an increased risk to the development multiple forms of cancer among people with diabetes and with body mass index (BMI) of more than 25kg/meter².

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

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

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

• New cancer cases due to high body mass index (BMI) was 544,300 and due to diabetes was 280,000.
• New cancer cases between 1980 and 2002 due to increased prevalence of diabetes were 77,000 or 26.1 percent and due to increased prevalence, high body mass index (BMI) was 174,040 or 31.9 percent.
• Most of the new cancer cases due to higher body mass index (BMI) and diabetes occurred in western countries followed by countries in East Asia and southeast Asia.
• New cancer cases due to high body mass index (BMI) and diabetes are less common among countries with low-income and more common among high-income countries. But there was a big increase in new cancer cases in low and middle-income countries between 1980 and 2002.
• Liver cancer cases constitute about 42.8 percent of cancer cases in men followed by colorectal cancer. Breast cancer cases constitute about 29.7 percent of cancer cases in women followed by endometrial cancer.
• The strong association between cancer development and higher body mass index (BMI) and diabetes among women. The number of cancer cases in women was 496,700 when compared to just 295,900 cases in men.

New cancer cases are expected to increase further due to lifestyle changes. Cancer cases 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 insulin may be a form of oncogenic viruses as earlier studies show higher risk to colorectal and breast cancer with hyperinsulinemia. The cancer risk with insulin is irrespective of their body mass index (BMI). But the study could not show the cause and effect relationship between cancer and any risk factors.

Lead author of the Wellcome Trust and NIHR funded study was Dr. Jonathan Pearson-Stuttard, Imperial College in London. The study findings were 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. Both DNA and RNA virus may cause tumours or tumors in animals. In humans, all DNA virus and a single RNA virus may cause cancer.

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