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Type 2 diabetes and cancer: umbrella review of meta-analyses of observational studies - PubMed

  • ️Thu Jan 01 2015

Meta-Analysis

doi: 10.1136/bmj.g7607.

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Meta-Analysis

Type 2 diabetes and cancer: umbrella review of meta-analyses of observational studies

Konstantinos K Tsilidis et al. BMJ. 2015.

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Abstract

Objectives: To summarise the evidence and evaluate the validity of the associations between type 2 diabetes and the risk of developing or dying from cancer.

Design: An umbrella review of the evidence across meta-analyses of observational studies of type 2 diabetes with risk of developing or dying from any cancer.

Data sources: PubMed, Embase, Cochrane database of systematic reviews, and manual screening of references.

Eligibility criteria: Meta-analyses or systematic reviews of observational studies in humans that examined the association between type 2 diabetes and risk of developing or dying from cancer.

Results: Eligible meta-analyses assessed associations between type 2 diabetes and risk of developing cancer in 20 sites and mortality for seven cancer sites. The summary random effects estimates were significant at P=0.05 in 20 meta-analyses (74%); and all reported increased risks of developing cancer for participants with versus without diabetes. Of the 27 meta-analyses, eventually only seven (26%) compiled evidence on more than 1000 cases, had significant summary associations at P ≤ 0.001 for both random and fixed effects calculations, and had neither evidence of small study effects nor evidence for excess significance. Of those, only six (22%) did not have substantial heterogeneity (I(2)>75%), pertaining to associations between type 2 diabetes and risk of developing breast, cholangiocarcinoma (both intrahepatic and extrahepatic), colorectal, endometrial, and gallbladder cancer. The 95% prediction intervals excluded the null value for four of these associations (breast, intrahepatic cholangiocarcinoma, colorectal, and endometrial cancer).

Conclusions: Though type 2 diabetes has been extensively studied in relation to risk of developing cancer and cancer mortality and strong claims of significance exist for most of the studied associations, only a minority of these associations have robust supporting evidence without hints of bias.

© Tsilidis et al 2014.

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Comment in

  • Type 2 diabetes and risk of cancer.

    Satija A, Spiegelman D, Giovannucci E, Hu FB. Satija A, et al. BMJ. 2015 Jan 2;350:g7707. doi: 10.1136/bmj.g7707. BMJ. 2015. PMID: 25555822 No abstract available.

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