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ORIGINAL RESEARCH ARTICLE

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/ )
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Abstract

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.

Keywords
Meta-analysis
Diabetes Mellitus
Pancreatic cancer
Liver cancer
Colo-rectal cancer
Gastro-intestinal cancers
Funding
Nil.
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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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