The relation of type 2 diabetes and cancer

Research output: Contribution to journalArticle

101 Citations (Scopus)

Abstract

Increasing evidence indicates that individuals with type 2 diabetes (diabetes) are at elevated risk for several common human malignancies, including cancers of the colon, breast, endometrium, pancreas, and liver. In particular, the consistent positive results reported by prospective investigations make it unlikely that methodologic issues, occult tumors, or chance results could explain the findings. Since diabetes and impaired fasting glucose together affect >25% of Americans above age 50, even a moderate etiologic association (e.g., relative risk = 1.5) would explain >10% of involved malignancies. Laboratory studies have suggested biologically plausible mechanisms. Insulin, for example, is typically at high levels during the development and early stages of diabetes. Activation of the insulin receptor by its ligand, or cross-activation of the insulin-like growth factor-I receptor, has been shown to be mitogenic and promote tumorigenesis in various model systems. A "unifying concept," in fact, holds that hyperinsulinemia may underlie the cancer associations of several additional risk factors, including high waist circumference, visceral fat, waist-to-hip ratio, body mass index, sedentary lifestyle, and energy intake. In this review, we assess current evidence regarding the relation of type 2 diabetes with cancer, and evaluate the findings in terms of well-accepted criteria for establishing causality.

Original languageEnglish (US)
Pages (from-to)263-274
Number of pages12
JournalDiabetes Technology and Therapeutics
Volume3
Issue number2
DOIs
StatePublished - 2001

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Medical problems
Type 2 Diabetes Mellitus
Neoplasms
Chemical activation
Sedentary Lifestyle
IGF Type 1 Receptor
Waist-Hip Ratio
Intra-Abdominal Fat
Insulin Receptor
Hyperinsulinism
Waist Circumference
Endometrium
Energy Intake
Causality
Liver
Colonic Neoplasms
Tumors
Pancreas
Fasting
Carcinogenesis

ASJC Scopus subject areas

  • Endocrinology
  • Medicine (miscellaneous)
  • Clinical Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

The relation of type 2 diabetes and cancer. / Strickler, Howard; Wylie-Rosett, Judith; Rohan, Thomas E.; Hoover, D. R.; Smoller, S.; Burk, Robert D.; Yu, H.

In: Diabetes Technology and Therapeutics, Vol. 3, No. 2, 2001, p. 263-274.

Research output: Contribution to journalArticle

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