Table 2.
Incident type 2 diabetes and risk of early-onset and later-onset cancers according to type 2 diabetes onset age in the pooled NHS and NHS II
| Cancer outcome | Diagnosis of type 2 diabetes | ||
|---|---|---|---|
| No | Yes and early-onset (diagnosed at <40 years of age) | Yes and later-onset (diagnosed at ≥40 years of age) | |
| Total cancer* | |||
| Early-onset (diagnosed at <50 years of age) | |||
| No. of cases (6,520 in total) | 6,424 | 37 | 59 |
| Age-adjusted† | 1 (reference) | 1.43 (1.04–1.98) | 1.10 (0.85–1.42) |
| MV‡ | 1 | 1.48 (1.07–2.05) | 1.15 (0.89–1.49) |
| MV + BMI + WC§ | 1 | 1.47 (1.06–2.04) | 1.14 (0.88–1.48) |
| Later-onset (diagnosed at ≥50 years of age) | |||
| No. of cases (36,907 in total) | 33,482 | 44 | 3,381 |
| Age-adjusted† | 1 | 1.05 (0.78–1.42) | 1.22 (1.17–1.26) |
| MV‡ | 1 | 1.06 (0.78–1.42) | 1.23 (1.18–1.27) |
| MV + BMI + WC§ | 1 | 0.96 (0.71–1.29) | 1.15 (1.11–1.20) |
| P for heterogeneity‖ | 0.06 | 0.92 | |
| Diabetes-related cancer¶ | |||
| Early-onset (diagnosed at <50 years of age) | |||
| No. of cases (1,959 in total) | 1,908 | 23 | 28 |
| Age-adjusted† | 1 | 3.07 (2.03–4.65) | 1.74 (1.20–2.54) |
| MV‡ | 1 | 2.86 (1.89–4.35) | 1.61 (1.10–2.35) |
| MV + BMI + WC§ | 1 | 2.11 (1.38–3.23) | 1.22 (0.83–1.79) |
| Later-onset (diagnosed at ≥50 years of age) | |||
| No. of cases (24,850 in total) | 22,387 | 32 | 2,431 |
| Age-adjusted† | 1 | 1.32 (0.93–1.86) | 1.28 (1.23–1.34) |
| MV‡ | 1 | 1.33 (0.94–1.89) | 1.29 (1.23–1.35) |
| MV + BMI + WC§ | 1 | 1.16 (0.82–1.64) | 1.17 (1.12–1.22) |
| P for heterogeneity‖ | 0.03 | 0.92 | |
| Obesity-related cancer# | |||
| Early-onset (diagnosed at <50 years of age) | |||
| No. of cases (1,739 in total) | 1,697 | 18 | 24 |
| Age-adjusted† | 1 | 2.71 (1.70–4.33) | 1.65 (1.10–2.47) |
| MV‡ | 1 | 2.44 (1.52–3.91) | 1.47 (0.98–2.21) |
| MV + BMI +WC§ | 1 | 1.75 (1.08–2.82) | 1.08 (0.71–1.64) |
| Later-onset (diagnosed at ≥50 years of age) | |||
| No. of cases (22,980 in total) | 20,704 | 32 | 2,244 |
| Age-adjusted† | 1 | 1.35 (0.95–1.91) | 1.30 (1.24–1.35) |
| MV‡ | 1 | 1.37 (0.96–1.94) | 1.31 (1.25–1.37) |
| MV + BMI + WC§ | 1 | 1.18 (0.83–1.67) | 1.18 (1.13–1.24) |
| P for heterogeneity‖ | 0.17 | 0.61 | |
MV, multivariate; WC, waist circumference.
Total cancer included all types of cancer, except nonmelanoma skin cancers.
Stratified by age, cohort, and follow-up cycle.
Stratified by age, cohort, and follow-up cycle; adjusted for race, pack-years of smoking, physical activity, alcohol intake, AHEI, total energy intake, multivitamin use, family history of diabetes, family history of cancer, history of lower endoscopy within the previous 10 years, fasting glucose screening within the previous 2 years, mammography screening within the previous 2 years, menopausal status and postmenopausal hormone use, and oral contraceptive use.
Additionally adjusted for cumulative-averaged BMI and WC.
P for heterogeneity between cancers diagnosed at <50 and ≥50 years of age. Calculated using the likelihood ratio test in which models were fitted with a data duplication method.
Diabetes-related cancer included cancers of thyroid, esophagus, pancreas, liver, colorectum, gallbladder, breast (postmenopausal), endometrium, ovarian, kidney, and bladder, and non-Hodgkin lymphoma and leukemia.
Obesity-related cancer included cancers of thyroid, esophagus, pancreas, liver, colorectum, gallbladder, breast (postmenopausal), endometrium, ovarian, and kidney and myeloma.