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Exp Clin Endocrinol Diabetes 2010; 118(1): 4-8
DOI: 10.1055/s-0029-1243193
Mini-Review

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Diabetes Mellitus Type 2 – An Independent Risk Factor for Cancer?

V. A. Grote1 , S. Becker1 , R. Kaaks1
  • 1Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
Further Information

Publication History

received 11.11.2009 first decision 11.11.2009

accepted 11.11.2009

Publication Date:
01 February 2010 (online)

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Abstract

Epidemiological findings have shown up to two-fold increases in the risks of cancers of the colorectum, breast, endometrium, kidney (renal cell tumours), liver and pancreas among diabetes patients. In the present review, we address the question whether, on the basis of these epidemiological observations, type 2 diabetes should be considered a specific and independent risk factor for these various forms of cancer, due to its particular metabolic characteristics of glucose intolerance and hyperinsulinemia. On the basis of further epidemiological evidence among non-diabetic individuals, as well as recent studies examining the effects of different types of diabetes treatment on cancer risks, we conclude that chronic elevations in fasting and non-fasting blood levels of glucose and/or insulin are plausible independent risk factors for cancer, but that much of the increase in cancer risks associated with these two metabolic factors may occur within the normoglycaemic and insulinemic (non-diabetic) ranges. Furthermore, for some tumour types (e. g. cancer of the endometrium) the associations of risk with type 2 diabetes may to a large extent be due to, and at least partially confounded by, other obesity-related alterations in (e. g. sex steroid) metabolism that in part are independent of glucose and/or insulin metabolism. Specifically for pancreatic cancer, a major question, addressed in detail by other reviews, is whether associations of risk with plasma glucose, insulin or overt type 2 diabetes could be either a cause, or possibly also a consequence of tumour development (or both).

Key words

cancer - diabetes - metabolic features

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Correspondence

R. Kaaks

Division of Cancer

Epidemiology Deutsches Krebsforschungszentrum

Im Neuenheimer Feld 280

69120 Heidelberg

Germany

Phone: +49 6221 422 202

Fax: +49 6221 42 22 03

Email: r.kaaks@dkfz.de