Diabetes Mellitus and Incidence and Mortality of Gastric Cancer: A Meta-Analysis

T. Tian; L. Q. Zhang; X. H. Ma; J. N. Zhou; J. Shen

doi:10.1055/s-0031-1297969

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

Exp Clin Endocrinol Diabetes 2012; 120(04): 217-223
DOI: 10.1055/s-0031-1297969

Article

Diabetes Mellitus and Incidence and Mortality of Gastric Cancer: A Meta-Analysis

Authors

T. Tian^*

¹Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
L. Q. Zhang^*

²Department of Medical Oncology, the Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
X. H. Ma

¹Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
J. N. Zhou

³Department of General Surgery, the Affiliated Jiangsu Cancer Hospital of Nanjing Medical University, Nanjing, China
J. Shen

¹Department of Endocrinology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Abstract

Aims:

Epidemiologic studies have examined the possible associations between diabetes mellitus (DM) and gastric cancer (GC), but the results are inconclusive. We conducted a meta-analysis to assess the evidence regarding the associations between diabetes and incidences of, or mortality from, gastric cancer.

Methods:

PubMed, Embase and Web of Science were searched up to Oct 20, 2011. We identified studies that included effects estimates with 95% confidence intervals (CIs) of the associations between GC and diabetes. Summary RRs for the GC incidence and mortality were calculated using random-effects model; subgroup analyses were also performed. Heterogeneity among studies was examined using Q and I² statistics.

Results:

A total of 7 case-control and 18 cohort studies met the inclusion criteria. The summary RR showed a slightly statistical link between history of DM and GC incidence (RR=1.11, 95% CI: 1.00–1.24, p=0.045, I²=79.5%). In the subgroup analyses, a positive association was noted among the studies conducted in Asia (summary RR=1.19, 95% CI: 1.07–1.32, I²=29.8%). Additionally, slight associations between DM and GC were observed by pooling the data of type 2 DM, cohort studies and the studies controlling more confounders, respectively. Furthermore, mortality from GC with diabetes was increased compared with individuals without diabetes (summary RR=1.29, 95% CI: 1.04–1.59). No publication bias was found.

Conclusion:

Individuals with diabetes have an increased risk of developing gastric cancer, and are positively associated with gastric cancer mortality. Large better-designed cohort studies are needed to verify this conclusion.

Key words

diabetes mellitus - gastric neoplasm - epidemiology - meta-analysis

Full Text

References

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