Table 3.
Incident type 2 diabetes and risk of cancers according to type 2 diabetes onset age and cancer onset age based on refined timing in the pooled NHS and NHS II
| Onset age | Total cancer* | Diabetes-related cancer† | Obesity-related cancer‡ | |||
|---|---|---|---|---|---|---|
| Reference§ | Exposed | Reference§ | Exposed | Reference§ | Exposed | |
| Type 2 diabetes onset age: <40 years | ||||||
| Cancer onset age: ≥40 to <50 years | ||||||
| No. of cases | 5,457 | 36 | 1,623 | 23 | 1,450 | 18 |
| Age-adjusted‖ | 1 | 1.58 (1.14–2.20) | 1 | 3.54 (2.33–5.36) | 1 | 3.13 (1.96–5.00) |
| MV¶ | 1 | 1.66 (1.19–2.30) | 1 | 3.31 (2.17–5.03) | 1 | 2.83 (1.76–4.54) |
| MV + BMI + WC# | 1 | 1.66 (1.19–2.32) | 1 | 2.47 (1.61–3.78) | 1 | 2.05 (1.26–3.31) |
| Type 2 diabetes onset age: ≥40 to <50 years | ||||||
| Cancer onset age: ≥50 to <60 years | ||||||
| No. of cases | 10,661 | 243 | 6,114 | 161 | 5,954 | 155 |
| Age-adjusted‖ | 1 | 1.21 (1.07–1.38) | 1 | 1.50 (1.28–1.76) | 1 | 1.44 (1.23–1.69) |
| MV¶ | 1 | 1.25 (1.10–1.42) | 1 | 1.52 (1.30–1.79) | 1 | 1.46 (1.24–1.72) |
| MV + BMI + WC# | 1 | 1.17 (1.02–1.33) | 1 | 1.29 (1.10–1.52) | 1 | 1.26 (1.06–1.48) |
| Type 2 diabetes onset age: ≥50 to <60 years | ||||||
| Cancer onset age: ≥60 to <70 years | ||||||
| No. of cases | 11,582 | 590 | 8,617 | 445 | 7,975 | 413 |
| Age-adjusted‖ | 1 | 1.26 (1.16–1.37) | 1 | 1.29 (1.17–1.42) | 1 | 1.29 (1.17–1.42) |
| MV¶ | 1 | 1.25 (1.15–1.36) | 1 | 1.29 (1.17–1.42) | 1 | 1.29 (1.17–1.43) |
| MV + BMI + WC# | 1 | 1.14 (1.05–1.24) | 1 | 1.15 (1.04–1.27) | 1 | 1.14 (1.03–1.27) |
| Type 2 diabetes onset age: ≥60 years | ||||||
| Cancer onset age: ≥70 years | ||||||
| No. of cases | 11,239 | 1,350 | 7,656 | 944 | 6,775 | 851 |
| Age-adjusted‖ | 1 | 1.20 (1.14–1.27) | 1 | 1.25 (1.17–1.34) | 1 | 1.28 (1.19–1.37) |
| MV¶ | 1 | 1.20 (1.13–1.27) | 1 | 1.25 (1.17–1.34) | 1 | 1.29 (1.20–1.39) |
| MV + BMI + WC# | 1 | 1.14 (1.07–1.21) | 1 | 1.16 (1.08–1.25) | 1 | 1.19 (1.10–1.28) |
MV, multivariate; WC, waist circumference.
Total cancer included all types of cancer, except nonmelanoma skin cancers.
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.
Reference group: participants without type 2 diabetes diagnosed in the relevant age group.
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.