Type 2 diabetes and cancer

Umbrella review of meta-analyses of observationlal studies

Konstantinos K. Tsilidis, John C. Kasimis, David Lopez, Evangelia E. Ntzani, John P A Ioannidis

Research output: Contribution to journalReview article

179 Citations (Scopus)

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 (I2>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.

Original languageEnglish (US)
Article numberg7607
JournalBMJ (Online)
Volume350
DOIs
StatePublished - Jan 2 2015
Externally publishedYes

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Type 2 Diabetes Mellitus
Meta-Analysis
Cholangiocarcinoma
Neoplasms
Endometrial Neoplasms
Observational Studies
Colorectal Neoplasms
Breast
Gallbladder Neoplasms
Mortality
Information Storage and Retrieval
PubMed
Databases

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Tsilidis, K. K., Kasimis, J. C., Lopez, D., Ntzani, E. E., & Ioannidis, J. P. A. (2015). Type 2 diabetes and cancer: Umbrella review of meta-analyses of observationlal studies. BMJ (Online), 350, [g7607]. https://doi.org/10.1136/bmj.g7607

Type 2 diabetes and cancer : Umbrella review of meta-analyses of observationlal studies. / Tsilidis, Konstantinos K.; Kasimis, John C.; Lopez, David; Ntzani, Evangelia E.; Ioannidis, John P A.

In: BMJ (Online), Vol. 350, g7607, 02.01.2015.

Research output: Contribution to journalReview article

Tsilidis, Konstantinos K. ; Kasimis, John C. ; Lopez, David ; Ntzani, Evangelia E. ; Ioannidis, John P A. / Type 2 diabetes and cancer : Umbrella review of meta-analyses of observationlal studies. In: BMJ (Online). 2015 ; Vol. 350.
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