Hongfeng Tang & Yunzhao Hu & Yuli Huang

Received: 16 May 2014 / Accepted: 31 July 2014 # Springer-Verlag Berlin Heidelberg 2014

Abstract

Aims/hypothesis The results from prospective cohort studies of prediabetes (impaired fasting glucose and/or impaired glu- cose tolerance) and risk of cancer are controversial. We con- ducted a meta-analysis to evaluate the risk of cancer in asso- ciation with impaired fasting glucose and impaired glucose tolerance.

Methods The PubMed, EMBASE and Cochrane Library da- tabases were searched for prospective cohort studies with data on prediabetes and cancer. Two independent reviewers assessed the reports and extracted the data. Prospective studies were included if they reported adjusted RRs with 95% CIs for the association between cancer and prediabetes. Subgroup analyses were conducted according to endpoint, age, sex, ethnicity, duration of follow-up and study characteristics. Results Data from 891,426 participants were derived from 16 prospective cohort studies. Prediabetes was associated with an increased risk of cancer overall (RR 1.15; 95% CI 1.06, 1.23).

Yi Huang and Xiaoyan Cai contributed equally to this study.

Electronic supplementary material The online version of this article (doi:10.1007/s00125-014-3361-2) contains peer-reviewed but unedited supplementary material, which is available to authorised users.

Y. Huang : X. Cai : H. Tang : Y. Hu (*) : Y. Huang (*)
Clinical Medicine Research Center, The First People?s
Hospital of Shunde, Penglai Road, Daliang Town, Shunde District, Foshan 528300, People?s Republic of China
e-mail: huyunzhao4406@163.com
e-mail: hyuli821@163.com

M. Qiu
Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou, People?s Republic of China

P. Chen
Department of Laboratory Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People?s Republic of China

The results were consistent across cancer endpoint, age, dura- tion of follow-up and ethnicity. There was no significant difference for the risk of cancer with different definitions of prediabetes. In a site-specific cancer analysis, prediabetes was significantly associated with increased risks of cancer of the stomach/colorectum, liver, pancreas, breast and endometrium (all p < 0.05), but not associated with cancer of the bronchus/ lung, prostate, ovary, kidney or bladder. The risks of site- specific cancer were significantly different (p = 0.01) and were highest for liver, endometrial and stomach/colorectal cancer. Conclusions/interpretation Overall, prediabetes was associat- ed with an increased risk of cancer, especially liver, endome- trial and stomach/colorectal cancer.

Keywords Cancer . Impaired fasting glucose . Impaired glucose tolerance . Prediabetes . Risk factors