Association between Type 2 diabetes mellitus and gastrointestinal cancers: A meta-analysis

Annie Thomas1 EG Jinto1 Jini Sara Jacob1 Preethi Sara George1 Aleyamma Mathew1*
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1 Division of Cancer Epidemiology & Biostatistics, Regional Cancer Centre, Thiruvananthapuram, India
CP 2023, 5(2), 2548
Submitted: 17 March 2023 | Accepted: 24 May 2023 | Published: 7 June 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

Background: We analysed the association between Type 2 Diabetes Mellitus and pancreatic cancer (PaC), liver cancer (LC) and colo-rectal cancer (CRC) along with sub-group analysis on risk modification by duration of diabetes and gender-based differences. Methods: A systematic literature search was conducted using Pubmed, Google scholar, Medline and Scopus for observational studies on DM and gastro-intestinal cancers published over two decades from January 2005 till March 2023. Accordingly, 36 studies were selected (14 case-control and 22 cohort studies) estimated summary odds-ratio (OR)/risk-ratio (RR) using Mantel-Haenzel method along with 95%CI. Results: Among cohort studies, CRC showed highest risk (pooled RR=2.49, 95%CI: 2.43-2.54) followed by PaC (RR=2.06, CI:2.0-2.13) and LC (RR=1.70, CI:1.6-1.81). Among case-control studies, LC showed highest risk (OR=3.16, CI: 2.89-3.46) followed by PaC (OR=2.8, CI:2.48-3.17) and CRC (OR=1.43, CI:1.3-1.57). Risk of PaC with DM duration showed Only cohort studies of 2.31 (CI: 2.20-2.43) for DM <5yrs and RR of 1.67 (CI:1.57-1.77) for ≥ 5yrs. Higher risk in females than males, except in LC where males showed higher risk irrespective of study design. In conclusion, diabetes and gastro-intestinal cancers showed positive association which varied with duration of DM. Shorter DM duration was associated with more risk for PaC. Screening for markers of PaC in new-onset DM is advantageous. LC and CRC that develop with increasing duration of DM need frequent screening and regular follow-up for early detection and timely intervention. Males with DM are at greater risk of LC and efforts to reduce contributing risk factors, mainly alcoholism, are imperative.

Diabetes Mellitus
Pancreatic cancer
Liver cancer
Colo-rectal cancer
Gastro-intestinal cancers
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Conflict of interest
There is no competing interest that could be perceived as prejudicing the impartiality of the research reported.
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