Table 2.
Multivariable-adjusted cancer incidence rates and hazard ratios of all cancer and major site-specific cancers by glycated hemoglobin value in non-diabetic participants, and by diabetes in the Atherosclerosis Risk in Communities Study (ARIC), 1990–2006.
| Glycated Hemoglobin, % in Non-Diabetic Participants |
|||||
|---|---|---|---|---|---|
| Women‡ | Total | <5.0 | 5.0–5.6 | ≥5.7 | Diabetes* |
| All Cancer | |||||
| No. of cases | 1,208 | 92 | 695 | 303 | 118 |
| Person yrs of follow-up | 95,313 | 7,081 | 60,796 | 20,064 | 7,372 |
| Incidence rate† | 1,280.1 | 1,388.2 | 1,138.7 | 1,551.0 | 1,604.9 |
| HR (95% CI)1 | 1.22 (0.98,1.52) |
1.00 (Ref) |
1.37 (1.19,1.58) |
1.47 (1.20,1.79) |
|
| HR (95% CI)2 | 1.27 (1.02,1.58) |
1.00 (Ref) |
1.24 (1.07,1.44) |
1.30 (1.06,1.60) |
|
| Post-menopausal Breast Cancer |
|||||
| No. of cases | 379 | 21 | 238 | 77 | 43 |
| Person yrs of follow-up | 81,071 | 5,264 | 50,795 | 18,248 | 6,764 |
| Incidence rate† | 458.2 | 399.2 | 447.0 | 420.1 | 647.3 |
| HR (95% CI)1 | 0.91 (0.58,1.42) |
1.00 (Ref) |
0.94 (0.72,1.23) |
1.41 (1.01,1.98) |
|
| HR (95% CI)2 | 0.94 (0.60,1.47) |
1.00 (Ref) |
0.88 (0.67,1.15) |
1.30 (0.92,1.83) |
|
| Lung Cancer | |||||
| No. of cases | 130 | 8 | 73 | 37 | 12 |
| Person yrs of follow-up | 95,313 | 7,081 | 60,796 | 20,064 | 7,372 |
| Incidence rate† | 138.6 | 138.8 | 119.4 | 192.1 | 147.7 |
| HR (95% CI) 1 | 1.09 (0.52,2.26) |
1.00 (Ref) |
1.61 (1.06,2.44) |
1.44 (0.77,2.69) |
|
| HR (95% CI) 2 | 1.00 (0.48,2.08) |
1.00 (Ref) |
1.29 (0.84,2.00) |
1.35 (0.71,2.59) |
|
| Colorectal Cancer | |||||
| No. of cases | 129 | 10 | 73 | 29 | 17 |
| Person yrs of follow-up | 95,313 | 7,081 | 60,796 | 20,064 | 7,372 |
| Incidence rate† | 134.5 | 169.4 | 123.5 | 140.2 | 205.6 |
| HR (95% CI) 1 | 1.27 (0.65,2.46) |
1.00 (Ref) |
1.10 (0.70,1.73) |
1.78 (1.03,3.08) |
|
| HR (95% CI) 2 | 1.31 (0.67,2.55) |
1.00 (Ref) |
0.99 (0.62,1.57) |
1.55 (0.88,2.75) |
|
| Men | |||||
| All Cancer | |||||
| No. of cases | 1,449 | 106 | 853 | 384 | 106 |
| Person yrs of follow-up | 73,735 | 6,014 | 45,501 | 16,470 | 5,750 |
| Incidence rate† | 1,982.1 | 2,023.6 | 1,979.2 | 2,187.3 | 1,653.8 |
| HR (95% CI)1 | 1.00 (0.82,1.22) |
1.00 (Ref) |
1.11 (0.98,1.26) |
0.87 (0.71,1.07) |
|
| HR (95% CI)2 | 1.04 (0.85,1.27) |
1.00 (Ref) |
1.08 (0.95,1.22) |
0.85 (0.69,1.05) |
|
| All Cancer minus Prostate Cancer |
|||||
| No. of cases | 876 | 67 | 513 | 228 | 68 |
| Person yrs of follow-up | 73,735 | 6,014 | 45,501 | 16,470 | 5,750 |
| Incidence rate† | 1,182.6 | 1,263.1 | 1,155.7 | 1,353.4 | 1,087.4 |
| HR (95% CI)1 | 1.07 (0.83,1.38) |
1.00 (Ref) |
1.17 (1.00,1.38) |
0.99 (0.77,1.28) |
|
| HR (95% CI)2 | 1.16 (0.90,1.50) |
1.00 (Ref) |
1.11 (0.95,1.31) |
0.96 (0.74,1.24) |
|
| Prostate Cancer | |||||
| No. of cases | 573 | 39 | 340 | 156 | 38 |
| Person yrs of follow-up | 73,735 | 6,014 | 45,501 | 16,470 | 5,750 |
| Incidence rate† | 799.5 | 760.5 | 823.5 | 833.9 | 566.4 |
| HR (95% CI) 1 | 0.90 (0.65,1.26) |
1.00 (Ref) |
1.02 (0.84,1.24) |
0.71 (0.51,1.00) |
|
| HR (95% CI) 2 | 0.88 (0.63,1.22) |
1.00 (Ref) |
1.02 (0.84,1.25) |
0.71 (0.84,1.25) |
|
| Lung Cancer | |||||
| No. of cases | 222 | 9 | 127 | 71 | 15 |
| Person yrs of follow-up | 73,735 | 6,014 | 45,501 | 16,470 | 5,750 |
| Incidence rate† | 302.2 | 190.9 | 298.4 | 423.4 | 259.2 |
| HR (95% CI) 1 | 0.59 (0.30,1.16) |
1.00 (Ref) |
1.39 (1.03,1.88) |
0.82 (0.48,1.41) |
|
| HR (95% CI) 2 | 0.71 (0.36,1.40) |
1.00 (Ref) |
1.27 (0.93,1.73) |
0.85 (0.49,1.46) |
|
| Colorectal Cancer | |||||
| No. of cases | 139 | 16 | 72 | 33 | 18 |
| Person yrs of follow-up | 73,735 | 6,014 | 45,501 | 16,470 | 5,750 |
| Incidence rate† | 189.2 | 277.3 | 165.9 | 196.4 | 282.1 |
| HR (95% CI) 1 | 1.79 (1.04,3.08) |
1.00 (Ref) |
1.16 (0.76,1.78) |
1.80 (1.07,3.05) |
|
| HR (95% CI) 2 | 1.84 (1.07,3.18) |
1.00 (Ref) |
1.04 (0.67,1.60) |
1.52 (0.88,2.60) |
|
Abbreviations: No., number; yrs, years; HR, Hazard Ratio; CI, Confidence Interval
A participant was classified as having diabetes if he/she self-reported a diagnosis of diabetes and/or were taking medication to treat diabetes at the first or second visit.
The rate per 100,000 women/men is given standardized to the age and race distribution in the analytic cohort.
The Cox proportional hazards models were adjusted for:
age (continuous) at the second visit, and race/ethnicity (white, black);
covariates in (1) and ARIC study site, education level (less than high school, high school/equivalent, college or above), cigarette smoking status (never, former, current), cigarette-years smoked (continuous), body mass index (continuous), and waist circumference (continuous).
The Cox proportional hazards models for women were also adjusted for post-menopausal hormone use (no, yes).