umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Blood glucose and risk of incident and fatal cancer in the metabolic syndrome and cancer project (Me-Can): analysis of six prospective cohorts.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
Ulm University, Germany.
University of Bergen.
Malmö University Hospital.
Show others and affiliations
2009 (English)In: PLoS Medicine, ISSN 1549-1277, E-ISSN 1549-1676, Vol. 6, no 12, e1000201- p.Article in journal (Refereed) Published
Abstract [en]

 Background

Prospective studies have indicated that elevated blood glucose levels may increase the risk of cancer, but the strength of the association is unclear. We examined the association between blood glucose and cancer risk in a prospective study of six European cohorts. Methods and Findings The Metabolic syndrome and Cancer project (Me-Can) includes cohorts from Norway, Austria, and Sweden; the current study included 274,126 men and 275,818 women. Mean age at baseline was 44.8 years and mean follow-up time was 10.4 years. Excluding the first year of follow-up, 18,621 men and 11,664 women were diagnosed with cancer, and 6,973 men and 3,088 women died of cancer. We used Cox regression models to calculate relative risk (RR) for glucose levels, and included adjustment for body mass index (BMI) and smoking  status in the analyses. RRs were corrected for regression dilution ratio of glucose. RR (95% confidence interval) per 1 mmol/l increment of glucose for overall incident cancer was 1.05 (1.01-1.10) in men and 1.11 (1.05-1.16) in women, and corresponding RRs for fatal cancer were 1.15 (1.07-1.22) and 1.21 (1.11-1.33), respectively. Significant increases in risk among men were found for incident and fatal cancer of the liver, gallbladder and respiratory tract, for incident thyroid cancer and multiple myeloma, and for fatal rectal cancer. In women, significant associations were found for incident and fatal cancer of the pancreas, for incident urinary bladder cancer, and for fatal cancer of the uterine corpus, cervix uteri, and stomach.

Conclusions

Data from our study indicate that abnormal glucose metabolism, independently of BMI, is associated with an increased risk of cancer overall and at several cancer sites. Our data showed stronger associations among women than among men, and for fatal cancer compared to incident cancer.

 

Place, publisher, year, edition, pages
2009. Vol. 6, no 12, e1000201- p.
Keyword [en]
cohort studies, neoplasms, blood glucose
National Category
Cancer and Oncology
Research subject
Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-22562DOI: 10.1371/journal.pmed.1000201ISI: 000273060600015PubMedID: 20027213OAI: oai:DiVA.org:umu-22562DiVA: diva2:217136
Available from: 2009-12-22 Created: 2009-05-13 Last updated: 2015-06-05Bibliographically approved
In thesis
1. Metabolic factors and cancer risk: prospective studies on prostate cancer, colorectal cancer, and cancer overall
Open this publication in new window or tab >>Metabolic factors and cancer risk: prospective studies on prostate cancer, colorectal cancer, and cancer overall
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: A large number of prospective studies have shown that overweight and diabetes are related to an increased risk of many cancers, including colorectal cancer. In contrast, diabetes has been related to a decreased risk of prostate cancer, and overweight has been related to an increased risk of fatal, but not of incident, prostate cancer. Data from studies on metabolic factors related to overweight and diabetes, and the association with cancer risk, are limited.

 Aim: The aim of this thesis was to study metabolic factors in relation to risk of prostate cancer (paper I and III), colorectal cancer (paper II and V), and cancer overall (paper VI).

 Methods: Study designs were i) case-control studies, nested within the Northern Sweden Health and Disease Cohort (paper I and II), and ii) cohort studies of the Swedish Construction Workers cohort (paper III), and the Metabolic syndrome and Cancer project (Me-Can) comprising seven European cohorts (paper V and VI). Paper IV was a descriptive paper of Me-Can.

 Results, prostate cancer: In paper I, increasing levels of several factors related to insulin resistance (insulin, insulin resistance index, leptin, HbA1c, and glucose) were associated with a decreased risk of overall incident prostate cancer, and the associations were stronger for non-aggressive tumours. In paper III, increasing levels of blood pressure was associated with a significant decreased risk of overall incident prostate cancer and of non-aggressive tumours. Body mass index (BMI) was significantly positively related to fatal prostate cancer. 

 Results, colorectal cancer: In paper II, obesity, hypertension, and hyperglycaemia, were associated with an increased risk of colorectal cancer, and presence of two or three of these factors was associated with a higher risk than the presence of one single factor. In paper V, BMI was associated with a significant linear positive association with risk of colorectal cancer in men and women, and significant positive associations were also found in men for blood pressure and triglycerides. A high metabolic syndrome score, based on levels of BMI, blood pressure, glucose, cholesterol, and triglycerides, was associated with a significant increased risk of colorectal cancer in men and women. The association was stronger than for any of the factors in single, but there was no evidence of a positive interaction between these metabolic factors.

 Results, cancer overall: Blood glucose was significantly positively associated with risk of incident and fatal cancer overall, and at several specific sites. The associations were stronger in women than in men, and for fatal than for incident cancer.

 Conclusions: Results from these studies indicate that elevated blood glucose is related to an increased risk of cancer overall and at several specific sites, and further, that overweight and metabolic aberrations increase the risk of colorectal cancer in an additive way. The association with prostate cancer seems to be more complex; insulin resistance and high blood pressure were in our studies related to a decreased risk of overall incident prostate cancer and of non-aggressive tumours, whereas overweight increased the risk of fatal prostate cancer.

Place, publisher, year, edition, pages
Umeå: Institutionen för kirurgi och perioperativ vetenskap, 2009. 90 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1267
National Category
Urology and Nephrology
Research subject
Epidemiology
Identifiers
urn:nbn:se:umu:diva-22567 (URN)978-91-7264-784-8 (ISBN)
Distributor:
Urologi och andrologi, 901 85, Umeå
Public defence
2009-06-05, Sal B, byggnad 1 D, Umeå Universitetssjukhus, Umeå, 13:15 (English)
Opponent
Supervisors
Available from: 2009-05-19 Created: 2009-05-13 Last updated: 2010-03-26Bibliographically approved

Open Access in DiVA

fulltext(263 kB)154 downloads
File information
File name FULLTEXT01.pdfFile size 263 kBChecksum SHA-512
5fcb23b5ffb2cc4e328d367434eee0d72ad85716a47a1d769cd4f0184b985dbd60c5b98c523193e49e6412645b84607702440ef5cd9dec4b806d2bbb4ec26644
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Authority records BETA

Stocks, TanjaHallmans, GöranJonsson, HåkanStattin, Pär

Search in DiVA

By author/editor
Stocks, TanjaHallmans, GöranJonsson, HåkanStattin, Pär
By organisation
Urology and AndrologyNutritional ResearchOncology
In the same journal
PLoS Medicine
Cancer and Oncology

Search outside of DiVA

GoogleGoogle Scholar
Total: 154 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 157 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf