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Prospective study of cancer in Japanese patients with type 2 diabetes: the Fukuoka Diabetes Registry

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Abstract

Background

Although the association between type 2 diabetes and cancer has been reported, few epidemiological studies have been conducted in Japanese patients whose leading cause of death is cancer. We prospectively studied the incidence of site-specific cancer, risk factors for developing cancer, cancer death, and survival in Japanese patients with type 2 diabetes.

Methods

We followed 4923 participants (mean age, 65 years) with type 2 diabetes attending an outpatient diabetes clinic for a median of 5.3 years (follow-up rate, 99.0%).

Results

During the follow-up period, cancer occurred in 450 participants (incidence rate, 22.3/1000 person-years in men and 12.2/1000 person-years in women). In men, prostate cancer was the most common cancer (4.3/1000 person-years), colorectal cancer was the second (3.6/1000 person-years), and gastric cancer was the third (3.3/1000 person-years). In women, colorectal cancer was the most common cancer (2.6/1000 person-years), gastric cancer was the second (2.0/1000 person-years), and breast cancer was the third (1.4/1000 person-years). Smoking, male sex, low-density lipoprotein cholesterol, family history of cancer, and reduced intake of isoflavone daidzein were significant risk factors for developing cancer using multivariable Cox proportional hazards models. The leading cancer death was lung cancer in men and pancreatic cancer in women. The survival was the best for prostate cancer and the worst for pancreatic cancer (2-year cancer-specific survival 95.4%, 30.0%, respectively).

Conclusions

Since the leading cause of death in patients with type 2 diabetes is cancer in Japan, clinicians should be aware of epidemiological data regarding cancer besides diabetic complications.

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Acknowledgements

The authors thank Drs. Yutaka Kiyohara, Yasufumi Doi, Toshiharu Ninomiya, Shigenobu Kanba, Dongchon Kang, Shuzo Kumagai, Shinako Kaizu, Yoichiro Hirakawa, Chisa Matsumoto, Chie Kitaoka (Kyushu University), Nobutaka Tsutsu, Nobuhiro Sasaki (Fukuoka Red Cross Hospital), Kiyohide Nunoi, Yuichi Sato, Yuji Uchizono, Ayumi Yamauchi, Kaori Itoh, Chie Kono (St. Mary’s Hospital), Sakae Nohara, Hirofumi Imoto, Kazushi Amano, (Steel Memorial Yawata Hospital), Daisuke Gotoh, Toshitaka Himeno, Masae Toyonaga (Kyushu Central Hospital), Noriyasu Shinohara, Ayako Tsutsumi (Fukuoka Higashi Medical Center), Masahiro Nakano, Mina Matsuo, Shoko Morimoto, Tomoko Hyodo (Hakujyuji Hospital), Masae Minami (Clinic Minami Masae), Miya Wada (Wada Miya Naika Clinic), Yoshifumi Yokomizo (Yokomizo Naika Clinic), Masanori Kikuchi, Yohei Kikuchi (Kikuchi Naika Clinic), Riku Nomiyama (Suzuki Naika Clinic), Shin Nakamura (Nakamura Naika Clinic), Kenji Tashiro (Oshima Eye Hospital), Mototaka Yoshinari (Yoshinari Naika Clinic), Kojiro Ichikawa (Fukutsu Naika Clinic), Teruo Omae (Hisayama Research Institute For Lifestyle Diseases), Hiroaki Ooboshi, and Shigeru Tanaka (Fukuoka Dental College). The authors also thank clinical research coordinators Chiho Ohba (Hisayama Research Institute For Lifestyle Diseases) and Kayoko Sekioka, Yoko Nishioka (Kyushu University), and those in the administration office, Tomoko Matake (Hisayama Research Institute For Lifestyle Diseases) and Junko Ishimatsu (Kyushu University). In addition, we thank H. Nikki March, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding

This work was supported, in part, by the Japan Society for the Promotion of Science KAKENHI (Grant numbers 23249037 and 23659353 to M.I., and 16K00861 to H.F.) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan.

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Authors and Affiliations

  1. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan

    Masanori Iwase, Yasuhiro Idewaki, Udai Nakamura, Toshiaki Ohkuma, Hitoshi Ide, Yuji Komorita, Tamaki Jodai-Kitamura, Masahito Yoshinari & Takanari Kitazono

  2. Diabetes Center and Clinical Research Center, Hakujyuji Hospital, Fukuoka, Japan

    Masanori Iwase & Yasuhiro Idewaki

  3. Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Hiroki Fujii

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  1. Masanori Iwase
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Correspondence to Masanori Iwase.

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Iwase, M., Fujii, H., Idewaki, Y. et al. Prospective study of cancer in Japanese patients with type 2 diabetes: the Fukuoka Diabetes Registry. Diabetol Int 10, 260–267 (2019). https://doi.org/10.1007/s13340-019-00390-0

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