Diabetes mellitus, insulin treatment, diabetes duration, and risk of biliary tract cancer and hepatocellular carcinoma in a European Cohort

S. Schlesinger, K. Aleksandrova, T. Pischon, M. Jenab, V. Fedirko, E. Trepo, K. Overvad, N. Roswall, A. Tjønneland, M. C. Boutron-Ruault, G. Fagherazzi, A. Racine, R. Kaaks, V. A. Grote, H. Boeing, A. Trichopoulou, M. Pantzalis, M. Kritikou, A. Mattiello, S. SieriC. Sacerdote, D. Palli, R. Tumino, P. H. Peeters, H. B. Bueno-de-Mesquita, E. Weiderpass, J. R. Quirós, R. Zamora-Ros, M. J. Sánchez, L. Arriola, E. Ardanaz, M. J. Tormo, P. Nilsson, B. Lindkvist, M. Sund, O. Rolandsson, K. T. Khaw, N. Wareham, R. C. Travis, E. Riboli, U. Nöthlings

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Background: Evidence on associations between self-reported diabetes mellitus, diabetes duration, age at diabetes diagnosis, insulin treatment, and risk of biliary tract cancer (BTC) and hepatocellular carcinoma (HCC), independent of general and abdominal obesity is scarce. Patients and methods: We conducted a prospective analysis in the EPIC-cohort study among 363 426 participants with self-reported diabetes data. Multivariable adjusted relative risks and 95% confidence intervals were estimated from Cox regression models. In a nested case-control subset, analyses were carried out in HCV/HBV-negative individuals. Results: During 8.5 years of follow-up, 204 BTC cases [including 75 gallbladder cancer (GBC) cases], and 176 HCC cases were identified. Independent of body mass index and waist-to-height ratio diabetes status was associated with higher risk of BTC and HCC [1.77 (1.00-3.13) and 2.17 (1.36-3.47)]. For BTC, the risk seemed to be higher in participants with shorter diabetes duration and those not treated with insulin. Regarding cancer subsites, diabetes was only associated with GBC [2.72 (1.17-6.31)]. The risk for HCC was particularly higher in participants treated with insulin. The results were not appreciably different in HCV/HBV-negative individuals. Conclusion(s): This study supports the hypothesis that diabetes is a risk factor for BTC (particularly GBC) and HCC. Further research is required to establish whether diabetes treatment or duration is associated with these cancers.

Original languageEnglish
Article numbermdt204
Pages (from-to)2449-2455
Number of pages7
JournalAnnals of Oncology
Volume24
Issue number9
DOIs
Publication statusPublished - Sep 2013

Fingerprint

Biliary Tract Neoplasms
Gallbladder Neoplasms
Hepatocellular Carcinoma
Diabetes Mellitus
Insulin
Therapeutics
Abdominal Obesity
Proportional Hazards Models
Neoplasms
Body Mass Index
Cohort Studies
Confidence Intervals
Research

Keywords

  • Biliary tract neoplasms
  • Diabetes duration
  • Diabetes mellitus
  • Gallbladder neoplasms
  • Hepatocellular carcinoma
  • Insulin treatment

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Schlesinger, S., Aleksandrova, K., Pischon, T., Jenab, M., Fedirko, V., Trepo, E., ... Nöthlings, U. (2013). Diabetes mellitus, insulin treatment, diabetes duration, and risk of biliary tract cancer and hepatocellular carcinoma in a European Cohort. Annals of Oncology, 24(9), 2449-2455. [mdt204]. https://doi.org/10.1093/annonc/mdt204

Diabetes mellitus, insulin treatment, diabetes duration, and risk of biliary tract cancer and hepatocellular carcinoma in a European Cohort. / Schlesinger, S.; Aleksandrova, K.; Pischon, T.; Jenab, M.; Fedirko, V.; Trepo, E.; Overvad, K.; Roswall, N.; Tjønneland, A.; Boutron-Ruault, M. C.; Fagherazzi, G.; Racine, A.; Kaaks, R.; Grote, V. A.; Boeing, H.; Trichopoulou, A.; Pantzalis, M.; Kritikou, M.; Mattiello, A.; Sieri, S.; Sacerdote, C.; Palli, D.; Tumino, R.; Peeters, P. H.; Bueno-de-Mesquita, H. B.; Weiderpass, E.; Quirós, J. R.; Zamora-Ros, R.; Sánchez, M. J.; Arriola, L.; Ardanaz, E.; Tormo, M. J.; Nilsson, P.; Lindkvist, B.; Sund, M.; Rolandsson, O.; Khaw, K. T.; Wareham, N.; Travis, R. C.; Riboli, E.; Nöthlings, U.

In: Annals of Oncology, Vol. 24, No. 9, mdt204, 09.2013, p. 2449-2455.

Research output: Contribution to journalArticle

Schlesinger, S, Aleksandrova, K, Pischon, T, Jenab, M, Fedirko, V, Trepo, E, Overvad, K, Roswall, N, Tjønneland, A, Boutron-Ruault, MC, Fagherazzi, G, Racine, A, Kaaks, R, Grote, VA, Boeing, H, Trichopoulou, A, Pantzalis, M, Kritikou, M, Mattiello, A, Sieri, S, Sacerdote, C, Palli, D, Tumino, R, Peeters, PH, Bueno-de-Mesquita, HB, Weiderpass, E, Quirós, JR, Zamora-Ros, R, Sánchez, MJ, Arriola, L, Ardanaz, E, Tormo, MJ, Nilsson, P, Lindkvist, B, Sund, M, Rolandsson, O, Khaw, KT, Wareham, N, Travis, RC, Riboli, E & Nöthlings, U 2013, 'Diabetes mellitus, insulin treatment, diabetes duration, and risk of biliary tract cancer and hepatocellular carcinoma in a European Cohort', Annals of Oncology, vol. 24, no. 9, mdt204, pp. 2449-2455. https://doi.org/10.1093/annonc/mdt204
Schlesinger, S. ; Aleksandrova, K. ; Pischon, T. ; Jenab, M. ; Fedirko, V. ; Trepo, E. ; Overvad, K. ; Roswall, N. ; Tjønneland, A. ; Boutron-Ruault, M. C. ; Fagherazzi, G. ; Racine, A. ; Kaaks, R. ; Grote, V. A. ; Boeing, H. ; Trichopoulou, A. ; Pantzalis, M. ; Kritikou, M. ; Mattiello, A. ; Sieri, S. ; Sacerdote, C. ; Palli, D. ; Tumino, R. ; Peeters, P. H. ; Bueno-de-Mesquita, H. B. ; Weiderpass, E. ; Quirós, J. R. ; Zamora-Ros, R. ; Sánchez, M. J. ; Arriola, L. ; Ardanaz, E. ; Tormo, M. J. ; Nilsson, P. ; Lindkvist, B. ; Sund, M. ; Rolandsson, O. ; Khaw, K. T. ; Wareham, N. ; Travis, R. C. ; Riboli, E. ; Nöthlings, U. / Diabetes mellitus, insulin treatment, diabetes duration, and risk of biliary tract cancer and hepatocellular carcinoma in a European Cohort. In: Annals of Oncology. 2013 ; Vol. 24, No. 9. pp. 2449-2455.
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abstract = "Background: Evidence on associations between self-reported diabetes mellitus, diabetes duration, age at diabetes diagnosis, insulin treatment, and risk of biliary tract cancer (BTC) and hepatocellular carcinoma (HCC), independent of general and abdominal obesity is scarce. Patients and methods: We conducted a prospective analysis in the EPIC-cohort study among 363 426 participants with self-reported diabetes data. Multivariable adjusted relative risks and 95{\%} confidence intervals were estimated from Cox regression models. In a nested case-control subset, analyses were carried out in HCV/HBV-negative individuals. Results: During 8.5 years of follow-up, 204 BTC cases [including 75 gallbladder cancer (GBC) cases], and 176 HCC cases were identified. Independent of body mass index and waist-to-height ratio diabetes status was associated with higher risk of BTC and HCC [1.77 (1.00-3.13) and 2.17 (1.36-3.47)]. For BTC, the risk seemed to be higher in participants with shorter diabetes duration and those not treated with insulin. Regarding cancer subsites, diabetes was only associated with GBC [2.72 (1.17-6.31)]. The risk for HCC was particularly higher in participants treated with insulin. The results were not appreciably different in HCV/HBV-negative individuals. Conclusion(s): This study supports the hypothesis that diabetes is a risk factor for BTC (particularly GBC) and HCC. Further research is required to establish whether diabetes treatment or duration is associated with these cancers.",
keywords = "Biliary tract neoplasms, Diabetes duration, Diabetes mellitus, Gallbladder neoplasms, Hepatocellular carcinoma, Insulin treatment",
author = "S. Schlesinger and K. Aleksandrova and T. Pischon and M. Jenab and V. Fedirko and E. Trepo and K. Overvad and N. Roswall and A. Tj{\o}nneland and Boutron-Ruault, {M. C.} and G. Fagherazzi and A. Racine and R. Kaaks and Grote, {V. A.} and H. Boeing and A. Trichopoulou and M. Pantzalis and M. Kritikou and A. Mattiello and S. Sieri and C. Sacerdote and D. Palli and R. Tumino and Peeters, {P. H.} and Bueno-de-Mesquita, {H. B.} and E. Weiderpass and Quir{\'o}s, {J. R.} and R. Zamora-Ros and S{\'a}nchez, {M. J.} and L. Arriola and E. Ardanaz and Tormo, {M. J.} and P. Nilsson and B. Lindkvist and M. Sund and O. Rolandsson and Khaw, {K. T.} and N. Wareham and Travis, {R. C.} and E. Riboli and U. N{\"o}thlings",
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AU - Schlesinger, S.

AU - Aleksandrova, K.

AU - Pischon, T.

AU - Jenab, M.

AU - Fedirko, V.

AU - Trepo, E.

AU - Overvad, K.

AU - Roswall, N.

AU - Tjønneland, A.

AU - Boutron-Ruault, M. C.

AU - Fagherazzi, G.

AU - Racine, A.

AU - Kaaks, R.

AU - Grote, V. A.

AU - Boeing, H.

AU - Trichopoulou, A.

AU - Pantzalis, M.

AU - Kritikou, M.

AU - Mattiello, A.

AU - Sieri, S.

AU - Sacerdote, C.

AU - Palli, D.

AU - Tumino, R.

AU - Peeters, P. H.

AU - Bueno-de-Mesquita, H. B.

AU - Weiderpass, E.

AU - Quirós, J. R.

AU - Zamora-Ros, R.

AU - Sánchez, M. J.

AU - Arriola, L.

AU - Ardanaz, E.

AU - Tormo, M. J.

AU - Nilsson, P.

AU - Lindkvist, B.

AU - Sund, M.

AU - Rolandsson, O.

AU - Khaw, K. T.

AU - Wareham, N.

AU - Travis, R. C.

AU - Riboli, E.

AU - Nöthlings, U.

PY - 2013/9

Y1 - 2013/9

N2 - Background: Evidence on associations between self-reported diabetes mellitus, diabetes duration, age at diabetes diagnosis, insulin treatment, and risk of biliary tract cancer (BTC) and hepatocellular carcinoma (HCC), independent of general and abdominal obesity is scarce. Patients and methods: We conducted a prospective analysis in the EPIC-cohort study among 363 426 participants with self-reported diabetes data. Multivariable adjusted relative risks and 95% confidence intervals were estimated from Cox regression models. In a nested case-control subset, analyses were carried out in HCV/HBV-negative individuals. Results: During 8.5 years of follow-up, 204 BTC cases [including 75 gallbladder cancer (GBC) cases], and 176 HCC cases were identified. Independent of body mass index and waist-to-height ratio diabetes status was associated with higher risk of BTC and HCC [1.77 (1.00-3.13) and 2.17 (1.36-3.47)]. For BTC, the risk seemed to be higher in participants with shorter diabetes duration and those not treated with insulin. Regarding cancer subsites, diabetes was only associated with GBC [2.72 (1.17-6.31)]. The risk for HCC was particularly higher in participants treated with insulin. The results were not appreciably different in HCV/HBV-negative individuals. Conclusion(s): This study supports the hypothesis that diabetes is a risk factor for BTC (particularly GBC) and HCC. Further research is required to establish whether diabetes treatment or duration is associated with these cancers.

AB - Background: Evidence on associations between self-reported diabetes mellitus, diabetes duration, age at diabetes diagnosis, insulin treatment, and risk of biliary tract cancer (BTC) and hepatocellular carcinoma (HCC), independent of general and abdominal obesity is scarce. Patients and methods: We conducted a prospective analysis in the EPIC-cohort study among 363 426 participants with self-reported diabetes data. Multivariable adjusted relative risks and 95% confidence intervals were estimated from Cox regression models. In a nested case-control subset, analyses were carried out in HCV/HBV-negative individuals. Results: During 8.5 years of follow-up, 204 BTC cases [including 75 gallbladder cancer (GBC) cases], and 176 HCC cases were identified. Independent of body mass index and waist-to-height ratio diabetes status was associated with higher risk of BTC and HCC [1.77 (1.00-3.13) and 2.17 (1.36-3.47)]. For BTC, the risk seemed to be higher in participants with shorter diabetes duration and those not treated with insulin. Regarding cancer subsites, diabetes was only associated with GBC [2.72 (1.17-6.31)]. The risk for HCC was particularly higher in participants treated with insulin. The results were not appreciably different in HCV/HBV-negative individuals. Conclusion(s): This study supports the hypothesis that diabetes is a risk factor for BTC (particularly GBC) and HCC. Further research is required to establish whether diabetes treatment or duration is associated with these cancers.

KW - Biliary tract neoplasms

KW - Diabetes duration

KW - Diabetes mellitus

KW - Gallbladder neoplasms

KW - Hepatocellular carcinoma

KW - Insulin treatment

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