Association between age at diabetes diagnosis and subsequent incidence of cancer: a longitudinal population-based cohort
Objective
Diabetes presenting at younger age has more aggressive nature. We aimed to explore the association of age at type 2 diabetes mellitus (T2DM) diagnosis with subsequent cancer incidence in a large Chinese population.
Research design and methods
The prospective population-based longitudinal cohort included 428,568 newly diagnosed T2DM patients from 2011 to 2018. Participants were divided into six groups according to their age at diagnosis: 20-54, 55-59, 60-64, 65-69, 70-74, ≥75. The incidence of overall and 14 site-specific cancers were compared to Shanghai general population including 100,649,346 person-years.
Results
A total of 18,853 and 582,643 overall cancer cases were recorded in the T2DM cohort and the general population. The age-standardized rate of overall cancer in T2DM patients was 501 (95% CI: 491, 511) per 100,000 person years and the standardized incidence ratio (SIR) was 1.10 (1.09, 1.12). Younger age at T2DM diagnosis was associated with higher incidence of overall and site-specific cancers. SIRs for overall cancer with T2DM diagnosis at ages 20-54, 55-59, 60-64, 65-69, 70-74, and ≥75 years were 1.48 (1.41, 1.54), 1.30 (1.25, 1.35), 1.19 (1.15, 1.23), 1.16 (1.12, 1.20), 1.06 (1.02, 1.10) and 0.86 (0.84, 0.89) respectively. Similar trends were observed for site-specific cancers including respiratory, colorectum, stomach, liver, pancreatic, bladder, CNS, kidney, gallbladder cancer, and lymphoma among both males and females.
Conclusions
Our findings highlight the necessity of stratifying management for T2DM according to age of diagnosis. As with a range of vascular outcomes, age-standardised cancer risks are greater in younger compared to later onset T2DM.
